Prognostic value of ambulatory blood pressure monitoring

Ambulatory blood pressure monitoring has both advantages and disadvantages in clinical practice. The structural and functional organ abnormalities associated with hypertension are more closely correlated to 24-h blood pressure mean values than to clinic or other conventional sphygmomanometric blood pressures. Furthermore, an additional relationship can be seen between the incidence and severity of these abnormalities and the magnitude of day and night blood pressure changes or 24-h blood pressure variability. However, controlled prospective studies are still required to demonstrate that ambulatory blood pressure data are superior or add to the prognostic value of clinic blood pressure. Moreover, ambulatory blood pressure normalcy has not yet been properly defined. This suggests caution in the practical use of this technique, which should be limited to special groups of subjects (those with a possible alerting reaction to conventional blood pressure assessments, in whom home blood pressure measurements are unreliable) and should only be used by clinicians with expertise in the field.