Ambulatory blood pressure monitoring: from research to clinical practice

Evidence from the medical literature is reviewed to indicate that ambulatory monitoring of blood pressure (ABPM) is a better predictor of target organ damage and clinical outcome in the hypertensive patient than clinic measurements of blood pressure (BP). A re-analysis of the documented BPs from the placebo limb of the Medical Research Council's treatment trial of mild hypertension is presented to indicate the difficulties inherent in the advice given by the various published guidelines on the diagnosis and management of hypertension. Finally, it is argued that because ABPM identifies a similar proportion of patients for treatment as a more prolonged follow-up, its use should be considered in the evaluation of all patients with mild hypertension as they can be categorised rapidly with less risk of being 'lost to follow-up'.