Consensus Conference on Self-blood pressure measurement. Clinical applications and diagnosis

The present study was aimed at reviewing the medical literature devoted to the clinical applications of self-blood pressure monitoring (SBPM) and at providing some recommendations regarding the use of SBPM for diagnostic purposes. The lack of reliability of conventional blood pressure (BP) measurement is largely related to the extreme variability of BP over time. SBPM provides a large number of readings and can be used to predict the results of repeated clinical measurements. The use of SBPM in the diagnosis of white coat hypertension can be proposed as a screening test: if it gives a positive result (a low home BP), it should be confirmed by ambulatory BP monitoring (ABPM). SBPM could improve patients' compliance with medication. Last, SBPM may be cost-effective for the management of hypertensive patients, by reducing costs of medication, number of clinic visits and costs of cardiovascular morbidity. Compared with ABPM, SBPM seems to have a less value for the initial diagnosis of hypertension and for predicting prognosis. In contrast, it should be of more value for the long term follow-up of patients with white coat hypertension and for the evaluation of treatment efficacy in patients with sustained hypertension. The use of SBPM in diabetic hypertensives, in pregnant women and in the elderly is encouraged, but needs further evaluation.