ObjectiveTo establish the factors affecting the difference between screening and home blood pressure measurements.DesignA cross-sectional study.SettingGeneral population in a rural Japanese community, Ohasama, Japan.ParticipantsThere were 1789 community-based subjects aged⩾40 years, for whom blood pressure was measured at screening site (screening blood pressure) and at home (home blood pressure).ResultsMultiple stepwise regression analysis of all subjects demonstrated that screening pulse pressure was positively associated with the difference between screening and home blood pressure measurements for systolic blood pressure. Age, the use of antihypertensive medication, and smoking status were negatively associated with the difference between measurements of both systolic and diastolic blood pressure.ConclusionWe have demonstrated that age, smoking, antihypertensive medication, and screening pulse pressure are independent predictors of the magnitude of the difference between screening and home blood pressure measurements, suggesting that the necessity to consider these factors, for the detection of the subjects who may be inappropriately treated or misjudged following screening blood pressure measurements.