BP Measurement: Ambulatory vs. Casual

The epidemiology, consequences, and treatment benefits of hypertension therapy have all been based on office measurement of BP by clinicians ("casual BP"). Because of potential for wide variation of blood pressure from a single spot measurement, it is generally recommended that several measurements be taken before a diagnosis of hypertension is made. Though the reproducibility and correlation with target organ damage of ambulatory blood pressure monitoring (ABPM) surpass that of casual office measurement, expense, inconvenience, and lack of large population normative data preclude use of this tool routinely.

To compare the reproducibility of home BP measurements by the patient (HMBP), office BP by the clinician (OBP), and ABPM, 17 general practitioners enrolled 122 newly diagnosed hypertensives. Each patient underwent 20 OBP measurements, 16 HMBP measurements, and an ABPM during a seven-month study.

The authors found that reproducibility of ABPM was not superior to that obtained as OBP or HBP. They suggest that use of ABPM be restricted to scientific research arenas, in that, for instance, ABPM may reduce the required numbers of patients in randomized trials or may be especially useful in monitoring circadian patterns in BP.

Brueren M, et al. Am J Hypertens 1997;10:879-885.