Ambulatory blood pressure and prognosis

PROGNOSTIC INFORMATION: Ambulatory blood pressure monitoring provides three kinds of information, all of which might have prognostic significance: blood pressure level, amplitude of diurnal variation and short-term variability. BLOOD PRESSURE LEVEL: Existing data support the hypothesis that patients whose ambulatory blood pressure is low in comparison with clinic blood pressure (white-coat hypertension) have a relatively low risk of morbidity. AMPLITUDE OF DIURNAL RHYTHM OF BLOOD PRESSURE: While there is limited support for the hypothesis that patients with small diurnal variations may carry a higher risk (particularly women), opposing hypotheses are also plausible. SHORT-TERM BLOOD PRESSURE VARIABILITY: It is hypothesized that increased variability will be associated with increased morbidity. Preliminary data from the Cornell prospective study are consistent with this hypothesis.