Clinical use of ambulatory blood pressure monitoring. A review of value in patient care

OBJECTIVE: To examine the value of ambulatory blood pressure monitoring in routine clinical use. DESIGN: We retrospectively reviewed 350 determinations made over a 4-year period. SETTING AND PATIENTS: A practice-based sample of patients attending the Hypertension Outpatient Clinic. RESULTS: Successful records were obtained in 346 of these procedures and night/sleep recordings were accomplished in 320. Monitor readings compared satisfactorily with auscultatory determinations. Declines in systolic and diastolic blood pressure during night/sleep of 8.2% and 13.2%, respectively, and a fall in the heart rate of 12.0% were noted; these declines were significantly lesser in patients with diabetes. Age, gender, therapy, and 24-hour average blood pressures, however, had minimal relationship to the night/sleep declines in blood pressure and heart rate. CONCLUSIONS: Twenty-four-hour blood pressure monitoring is acceptable to patients. Night/sleep declines in blood pressure are blunted in diabetics.