[Technical possibilities and limits of ambulatory 24-hour blood pressure measurement]

Noninvasive automatic 24-h indirect ambulatory monitoring of blood pressure (ABPM) and heart rate has been performed in more than 2000 subjects from 1983-1990 using 12 different devices. According to the requirements of national validation authorities (e.g. AAMI, PTB and BHS) only four devices have passed at least two protocols. These monitors were equipped with auscultatory and/or oscillometric devices; they provided accurate readings and were repeatedly used up to eight times in some patients. Up to 100 data points per 24-h provided diurnal blood pressure profiles for over 91% of the patients in clinical and non-clinical situations. Early identification of borderline hypertensives at risk and detailed information on the efficacy of different anti-hypertensive regimes may in part justify the high costs of the monitors. Although sleep disturbance continued in more than 20% of investigated patients, the new lighter, quieter monitors (e.g., SL 90207, 380 g) were well received by patients and nurses. In the future, simultaneous registration with 24-h ECG may help in identifying the effects of different antihypertensive therapies on blood pressure variabilities and rhythmicity of the heart rate. The cost-benefit-ratio and the prognostic importance have yet to be defined.