Control of blood pressure in the ambulatory setting

Control of blood pressure still relies on conventional office or clinical blood pressure measurement using mercury sphygmomanometry. However, it has long been known that office measurement, even when repeated, does not fully reflect usual blood pressure. The additional use of ambulatory devices for prolonged periods of blood pressure measurement is now clinically feasible. Previous research has indicated that ambulatory blood pressure measurement is better than office measurement at predicting individual cardiovascular risk. Guidelines for clinical use of ambulatory blood pressure measurement and for quality control of devices are available. Ambulatory measurement has revealed characteristics of circadian rhythm and variability that are promising with regard both to improving our understanding of the aetiology of high blood pressure and to individual risk assessment. Some of the latest developments in research on ambulatory blood pressure measurement are discussed.