Application and Effects of Ambulatory Blood Pressure Monitoring in Primary Care

Ambulatory blood pressure monitoring (ABPM) is well-recognized as a valuable tool in diagnosing and managing hypertension and is more predictive of cardiovascular events than office or home blood pressure readings. Yet concerns remain, particularly in the US, about whether ABPM can be implemented in a primary care practice, be delivered in an efficient manner, and yield influential information. ABPM was made available within a 17-physician internal medicine primary care clinic and was utilized for routine blood pressure management. Patients wore the ABPM device for 24 hours, with readings taken every 20 to 30 minutes. Data were collected on 3,217 patients who underwent ABPM between January 2013 and October 2016. Of the 3,217 patients who underwent ABPM, 43% of patients had their blood pressure control status reclassified. Reclassification was not limited to near-normal office blood pressure readings. Among those with systolic blood pressure >160 mm Hg, 38% were reclassified as normotensive. Among...