Ambulatory versus casual blood pressure in the diagnosis of hypertensive patients

Recent advances in medical technology have enabled the development of fully automatic portable noninvasive blood pressure recorders which can reliably monitor changes of blood pressure over periods of 24 hour or more. The commercial availability of such recorders raises the question of their relevance to the practical management of hypertensive patients. The rationale for the use of Ambulatory Blood Pressure monitoring (ABPM) is the enormous variability of blood pressure. This has been amply demonstrated with both invasive and noninvasive ABPM, and is not a matter of dispute (1,2). Since the adverse effects of blood pressure on the circulation are thought to depend either on the average level of pressure over time or possibly also on the peak levels of pressure, there is a sound theoretical reason for thinking that multiple measurementspage missing 258-258