[37] The same SR compared AOBP and HPBM using pooled data from seven studies and also found no statistically significant difference in SBP and DBP between the two methods. Similar findings from 19 studies were reported in another SR by Roerecke et al. (2019), which demonstrated a non-significant pooled mean difference in SBP of 0.3 mm Hg (95% CI -1.1 to 1.7 mm Hg) between AOBP and awake ABPM in patients who had an office SBP >130 mm Hg.[38] The Work Group did not find any evidence comparing the predictive value of AOBP versus out-of-office blood pressure on clinical outcomes. Another key reason for the recommendation to preferentially use ABPM and HBPM in the 2014 VA/DoD HTN CPG was the ability of out-of-office blood pressure to assist in the identification of white coat and masked HTN in untreated individuals, as well as uncontrolled white coat and uncontrolled masked HTN in patients receiving antihypertensive medications. The 2014 VA/DoD HTN CPG, 2015 USPSTF,[20] and 2017 AHA/ACC [4] guidelines all recommended ruling out white coat HTN in individuals with newly diagnosed elevated office blood pressure to avoid unnecessary initiation of drug therapy. Since the evidence review and HTN outcome trials in general did not identify or exclude patients with white coat HTN as distinct from other forms of HTN, it is possible that white coat HTN is not a totally benign condition. Accordingly, it is unknown whether patients with white coat HTN benefit or do not benefit from treatment. Therefore, the Work Group concluded there was very low quality evidence supporting the utility of out-of-office blood pressure measurements in confirming diagnosis of HTN prior to the initiation of drug therapy. 