American Board of Internal Medicine (ABIM) Certification Practice Exam

An average 24-hour ABPM of 130/80 mm Hg corresponds to which clinic blood pressure?

1. 120/80 mm Hg

2. 125/80 mm Hg

3. 140/90 mm Hg

4. 135/90 mm Hg

The correct answer is: 140/90 mm Hg

An average 24-hour ambulatory blood pressure monitoring (ABPM) reading of 130/80 mm Hg typically corresponds to a higher clinic blood pressure value due to the phenomenon known as "white coat syndrome" and the variability in blood pressure readings. In practice, it has been observed that a 24-hour ABPM average is usually lower than clinic readings because clinic measurements can be influenced by factors such as anxiety or stress during the visit. This variability suggests that the average clinic blood pressure tends to be higher than the average ABPM reading. Given this context, a clinic blood pressure reading of 140/90 mm Hg is appropriate as it represents the expected hypertensive range that can be correlated with an average ABPM of 130/80 mm Hg. This aligns with clinical guidelines suggesting that a significant difference often exists between the two types of blood pressure measurements, leading to a higher clinic reading in patients whose average ABPM reflects controlled hypertension. Thus, 140/90 mm Hg accurately reflects the relationship between an average ABPM reading of 130/80 mm Hg and what might be seen in a clinic setting.