Ash recommendations on the clinical use of home and ambulatory blood pressure monitoring

Blood pressure measurements made outside the office or clinic setting may be helpful in the diagnosis and management of hypertensive patients, as an adjunct to the office readings. Both self (at home or at work) and ambulatory monitoring are recommended in selected patients. For both types of monitoring, automatic or semi-automatic monitors are available; only those brands which have been validated and found to be accurate according to standard protocols should be used. Self monitoring is relatively inexpensive, and is recommended both for the initial diagnosis of hypertension and for the evaluation of the response to treatment. Patients should have their monitoring technique validated by trained personnel. Ambulatory monitoring is not recommended for the routine evaluation of hypertensive patients, but is of value when it is suspected that the clinic measurements may be unrepresentative of the pressure at other times, e.g. in patients with suspected white coat hypertension. Other indications of potential value include assessment of resistant hypertension, hypotensive symptoms associated with antihypertensive medication, and autonomic neuropathy. Detailed recommendations will be presented at the ASH Annual Meeting.