Patients who nd ABPM and HBPM to be uncomfortable and inconvenient may prefer not to use such devices. Key information Balance of bene ts and harms. This recommendation places a relatively higher value on assessing a patient s broader BP pro le than relying solely on standardized of ce BP mea- surements. Observational studies indicate that the diagnosis of high BP and BP control status differs for a high proportion of adults when BP is measured in the of ce versus outside the of ce, which can lead to detection of masked hypertension, masked uncontrolled hypertension, white-coat hyperten- sion, and the white-coat effect (Figure 4). Further, obser- vational studies indicate a stronger association of out-of-of ce BP measurements with CV and kidney outcomes than of ce BP measurements in the general population and CKD.29 31 Masked hypertension and masked uncontrolled hyper- tension are present among 9% 30% of adults without high BP based on of ce measurements and are associated with higher risk for CV disease and kidney outcomes compared with sustained normotension and sustained controlled hy- pertension, respectively. White-coat hypertension and the white-coat effect are present among 15% 30% of adults with high BP based on of ce measurements. In a recent meta- analysis, white-coat hypertension was associated with a Not taking antihypertensive medication White-coat hypertension Sustained hypertension Normotension Masked hypertension Hypertension based on standardized office BP Hypertension based on out-of-office BP Yes Yes No No Taking antihypertensive medication White-coat effect Sustained uncontrolled hypertension Sustained controlled hypertension Masked uncontrolled hypertension Hypertension based on standardized office BP Hypertension based on out-of-office BP Yes Yes No No Figure 4 | Blood pressure patterns informed by out-of-of ce blood pressure measurements in addition to standardized of ce blood pressure measurement. 