National High Blood Pressure Education Program Working Group Report on Ambulatory Blood Pressure Monitoring

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Abstract
• Blood pressure measurements obtained in a physician's office may not represent a patient's blood pressure during an entire day. Ambulatory blood pressure monitoring (ABPM) provides multiple readings over time. This review of the literature on ABPM addresses the current state of ABPM methods, normal blood pressure profiles, the clinical and research uses of ABPM, cost considerations, and recommendations for use of ABPM in selected circumstances. Current ABPM devices use either auscultatory or oscillometric methods to determine blood pressure. A rigorous comparison of these methods is needed to determine whether one method is more reliable. A nonbiased assessment of all available equipment is necessary. Normative data provided by ABPM research are needed for populations by age, race, gender, body habitus, and conditions, such as pregnancy. While ABPM is not cost-effective for all hypertensive patients, it can assist in the evaluation of such problems as target organ complications, syncopal episodes, episodic hypertension, and autonomic dysfunction. (Arch Intern Med. 1990;150:2270-2280)