BP should optimally be measured at about the same time of day and before medications are taken to estimate the trough or nadir effect.
Smoking transiently raises the BP; thus, the office BP may underestimate the usual BP in a heavy smoker who has not smoked for more than 30 minutes before the measurement is made.
Caffeine intake can raise the BP acutely, primarily in non-habitual coffee drinkers.
Taking the BP in a cool room (12ºC or 54ºF) or while the patient is talking can raise the measured value by as much as 8 to 15 mmHg.
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