This recommendation is strong because, in the Work Group s opinion, the importance of of ce BP measured using a standardized versus a routine, non-standardized approach outweighs any potential burden to its implementation. Key information Balance of bene ts and harms. This recommendation relies heavily on the importance of standardized of ce BP mea- surement protocols that are consistent with large randomized controlled trials (RCTs) with clinically important outcomes that have been used to de ne BP targets. Standardized of ce BP measurements allow for extrapolation of the RCT ndings to clinical practice and avoid overtreatment or undertreat- ment of high BP that may occur if non-standardized mea- surements are used. The negative aspects of standardized of ce BP measurement, including the increased burden on patient, provider, staff time, and clinic space, are outweighed by the bene ts. Quality of evidence. There is moderate-quality evidence that routine of ce BP is generally, but not invariably, higher than standardized of ce BP, regardless of whether manual or oscillometric devices are used. However, there is strong evidence that the relationship between routine of ce BP and standardized of ce BP is highly variable among individuals. Thus, it is not possible to apply a correction factor to translate a given routine BP value to standardized of ce BP. Values and preferences. Appropriate BP management re- quires proper BP measurements. All large randomized BP outcome trials used standardized of ce BP measurements. In the opinion of the Work Group, the importance of measuring BP in a manner that is consistent with the RCTs far outweighs the additional burdens and costs for providers, staff, and patients. Increased costs are due to personnel and clinic time utilization. 