[Ambulatory long-term blood pressure determination: technique and ways of risk identification]

Traditional noninvasive measurement of blood pressure with the sphygmomanometer has as a punctual method been considerably expanded by the development of methods for recording blood pressure repeatedly under normal daily activity. Such procedures have contributed much to understanding of circadian regulation of blood pressure. Normo- and hypertensive patients experience a physiologic drop in systolic and diastolic blood pressure during night hours. Ambulatory blood pressure recordings are suitable to increase treatment compliance by patients. They allow qualitative evaluation of antihypertensive treatments and elimination of overshooting reactions to the measuring process by the physician (white-coat effect). This method has the potential for better definition of cardiovascular risk factors through recording of circulatory stress by blood pressure. No accepted guidelines exist, however, to date for definition of normal values for such measurements. The upper limits of normality for averaged blood pressure appear to be 140/90 mmHg during the day and 120/80 mmHg at night.