Document Type
Article
Publication Date
4-2025
Degree Name
Doctor of Nursing Practice
Abstract
Background White coat hypertension (WCH) affects around 12-15% of the population and may lead to a misdiagnosis of hypertension (HTN) and unnecessary treatment. The American College of Cardiology (ACC) and the American Heart Association (AHA) recommend home BP monitoring (HBPM) to aid in differentiating between WCH and HTN. A HBPM program was implemented in a primary care office.
Project Goals
1. Educate providers about the ACC/AHA guidelines promoting HBPM to assist in differentiating between WCH and HTN in patients with elevated office blood pressures (BP).
2. Implement a HBPM algorithm for patients presenting with a BP > 130/80 mmHg.
Methods The DNP student received a donation of over 40 Braun BP machines. Patients with an in-office BP > 130/80mmHg were provided a BP machine and instructed to track BP at home for several weeks. An educational sheet and BP logs were distributed to ensure proper technique. Based on home readings, patients were diagnosed with either WCH or essential HTN.
Results Sixteen participants (48%) returned completed BP logs. Four (25%) were diagnosed with WCH. Twelve patients (75%) fit the essential HTN criteria. Of those 12 patients, 8 (66%) had anti-hypertensive medications initiated, or an additional anti-hypertensive added to their regimen.
Conclusion
Home BP monitoring enhanced diagnostic accuracy and supported shared decision-making between providers and patients. This approach should be standard for patients with office BP readings > 130/80mmHg.
Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial-Share Alike 4.0 International License.
Recommended Citation
Peterson, J. (2025). Implementing home blood pressure monitoring to identify essential hypertension: A quality improvement project [Unpublished DNP project]. Sacred Heart University. https://digitalcommons.sacredheart.edu/dnp_projects/86
Comments
A DNP project submitted in partial fulfillment of the requirements for the degree of Doctor of Nursing Practice, Sacred Heart University Davis & Henley College of Nursing.