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When and how to use self (home) and ambulatory blood pressure monitoring
Thomas G Pickering1, William B White,
1Center for Behavioral Cardiovascular Health, Columbia Presbyterian Medical Center, New York, New York, USA.
Insights
Out-of-office blood pressure (BP) monitoring, including ambulatory BP monitoring (ABPM) and home BP monitoring, is crucial for managing hypertension. These methods help identify high-risk patients and improve diagnosis of conditions like white-coat hypertension.
Area of Science:
- Cardiology
- Hypertension Management
Background:
- Out-of-office blood pressure (BP) measurement is vital for clinical hypertension management.
- Studies link ambulatory BP and BP reduction patterns to cardiovascular risk.
Purpose of the Study:
- To highlight the importance of out-of-office BP measurement for hypertension and its complications.
- To discuss the roles of ambulatory BP monitoring (ABPM) and home BP monitoring (HBPM) in patient evaluation and risk stratification.
Main Methods:
- Review of studies on ambulatory BP monitoring (ABPM).
- Analysis of data on self-monitoring of BP (home BP monitoring).
- Comparison of out-of-office BP data with clinic BP readings.
Main Results:
- Ambulatory BP is directly associated with cardiovascular risk.
- BP reduction from day to night is inversely associated with risk.
- ABPM identifies high-risk patients independently of office BP.
- HBPM has advantages for evaluating patients on drug treatment.
Conclusions:
- Out-of-office BP monitoring enhances the identification of white-coat and masked hypertension.
- These methods are valuable for assessing BP control in patients on therapy.
- ABPM and HBPM improve clinical decision-making in hypertension management.
Abstract:
This American Society of Hypertension position paper focuses on the importance of out-of-office blood pressure (BP) measurement for the clinical management of patients with hypertension and its complications. Studies have supported direct and independent associations of cardiovascular risk with ambulatory BP and inverse associations with the degree of BP reduction from day to night. Self-monitoring of the BP (or home BP monitoring) also has advantages in evaluating patients with hypertension, especially those already on drug treatment, but less is known about its relation to future cardiovascular events. Data derived from ambulatory BP monitoring (ABPM) allow the identification of high-risk patients, independent from the BP obtained in the clinic or office setting. While neither ABPM nor self-BP monitoring are mandatory for the routine diagnosis of hypertension, these modalities can enhance the ability for identification of white-coat and masked hypertension and evaluate the extent of BP control in patients on drug therapy.
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