ASH Position Paper: Home and Ambulatory Blood Pressure Monitoring When and How to Use Self (Home) and Ambulatory Blood Pressure Monitoring
Why the study?
Does out-of-office blood pressure monitoring (home and ambulatory) improve the accuracy of blood pressure evaluation and cardiovascular risk prediction compared to traditional office measurement in patients with suspected or treated hypertension?
Population
Patients undergoing blood pressure evaluation for suspected or treated hypertension
Comparison
Out-of-office blood pressure monitoring vs Traditional office blood pressure measurement
Design
Guideline
Authors
Discussion
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Member takes
Implication
Supports routine adoption of validated home and ambulatory BP monitoring in hypertension care; reinforces Level 1 guideline consensus on superior risk prediction.
Key Points
- Out-of-office blood pressure measurements identify white-coat hypertension and masked hypertension better than traditional clinic visits.
- A 24-hour ambulatory blood pressure of 130/80 mm Hg and a home blood pressure threshold of 135/85 mm Hg define key treatment cutoffs.
- Guideline recommendations detail standardized oscillometric cuff protocols to monitor treatment response and nocturnal blood pressure.
Structured PICO
Does out-of-office blood pressure monitoring (home and ambulatory) improve the accuracy of blood pressure evaluation and cardiovascular risk prediction compared to traditional office measurement in patients with suspected or treated hypertension?
P
Population
Patients undergoing blood pressure evaluation for suspected or treated hypertension
I
Intervention
Out-of-office blood pressure monitoring (self/home blood pressure monitoring and ambulatory blood pressure monitoring)
C
Comparator
Traditional office blood pressure measurement
O
Outcome
Accurate estimation of true blood pressure status and prediction of cardiovascular risk
The American Society of Hypertension recommends the use of validated home and ambulatory blood pressure monitoring to supplement office readings for more accurate cardiovascular risk prediction and diagnosis of white-coat or masked hypertension.
Cite This Study
Pickering et al. (2008) studied this question.