Emerging clinical roles for ambulatory blood pressure monitoring

Ambulatory blood pressure monitoring is becoming increasingly popular in the diagnosis and treatment of patients with hypertensive disorders. Widespread clinical use, however, has been limited by a lack of normative data and prospective, controlled clinical studies of its impact on subsequent cardiovascular morbidity and mortality. Particular applications of this technology include the investigation of white coat hypertension and correlation of the components of diurnal blood pressure variation with hypertension-associated target organ damage. Recently, interest has extended to the role of different physiologic states such as pregnancy and aging, as well as racial and other genetic differences, in the development of hypertension and susceptibility to target organ damage, and the study of hypertension associated with diabetes mellitus, renal disease, and organ transplantation. This review summarizes recent studies in these areas in addition to discussing the current clinical indications, limitations, and future research directions of ambulatory blood pressure monitoring.