December 1, 1999Blood Pressure Monitoring
Task Force IV: Clinical use of ambulatory blood pressure monitoring
Why the study?
Does ambulatory blood pressure monitoring (ABPM) improve the diagnosis and management of hypertension compared to conventional blood pressure measurement?
Population
Patients with elevated clinic blood pressures, suspected white-coat hypertension, borderline hypertension…
Comparison
Ambulatory blood pressure monitoring (ABPM) vs Conventional measurement of blood pressure
Design
Guideline
Authors
Discussion
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Member takes
Implication
ABPM should guide antihypertensive decisions to avoid overtreatment; reinforces consensus on its prognostic value and indications including nocturnal hypertension.
Key Points
- To establish an international expert consensus on the diagnostic indications, clinical value, and limitations of ambulatory blood pressure monitoring (ABPM) in routine practice.
- Task force consensus statement drafted for and amended following the Seventh International Consensus Conference (Leuven, Belgium, 1999).
- Evaluated clinical utility, prognostic validity, and cost-effectiveness of validated ABPM devices compared with conventional Riva-Rocci/Korotkoff sphygmomanometry.
- ABPM outperforms conventional clinic blood pressure measurement in predicting cardiovascular risk and reliably diagnoses white-coat hypertension, defined as clinic blood pressure >140/90 mmHg with daytime ambulatory blood pressure <135/85 mmHg.
- Antihypertensive drug therapy lowers clinic blood pressure but fails to reduce ambulatory blood pressure or improve clinical prognosis in patients with isolated white-coat hypertension.
- ABPM uniquely detects nocturnal hypertension and is indicated for borderline hypertension, resistant hypertension, elderly patients, pregnant women, and suspected hypotension.
Structured PICO
Does ambulatory blood pressure monitoring (ABPM) improve the diagnosis and management of hypertension compared to conventional blood pressure measurement?
P
Population
Patients with elevated clinic blood pressures, suspected white-coat hypertension, borderline hypertension, elderly, pregnant women, treatment-resistant hypertension, and symptoms suggestive of hypotension
I
Intervention
Ambulatory blood pressure monitoring (ABPM)
C
Comparator
Conventional measurement of blood pressure (sphygmomanometry)
O
Outcome
Diagnosis of white-coat hypertension and assessment of antihypertensive treatment effectssurrogate
ABPM is a valuable accessory to conventional blood pressure measurement, particularly for identifying white-coat hypertension and assessing the efficacy of antihypertensive therapy.
Cite This Study
Staessen et al. (1999) studied this question.