A CONSENSUS VIEW ON THE TECHNIQUE OF AMBULATORY BLOOD-PRESSURE MONITORING

This review, based on the Fourth International Consensus Conference on Ambulatory Blood Pressure Monitoring (Leuven, Belgium. 1994), deals w ith the technical aspects of ambulatory blood pressure monitoring. Amb ulatory blood pressure monitoring by noninvasive intermittent techniqu es is widely used despite artifacts due to cuff size, movement, body p osition, short-term blood pressure variability, and interference with sleep. The performance of the currently available monitors under truly ambulatory conditions and during exercise remains a matter of debate, as are the procedures required to validate portable monitors under th ese circumstances. There is general agreement that whenever a monitor is to be used in special populations, such as older subject's or pregn ant women, or in special conditions, such as exercise, a specific demo nstration of its accuracy in these defined subgroups or conditions is warranted. Whether the auscultatory or oscillometric method is preferr ed remains controversial because each technique has specific advantage s and disadvantages and because both can provide accurate results. Mos t experts in the field strongly believe that manufacturers should disc lose the algorithms of their devices and that they should specify all changes made to the hardware and software of a previously validated mo nitor. Finally, the development of the volume-damp method, which makes continuous noninvasive registration of blood pressure at the finger p ossible in both stationary and ambulatory conditions, opens new perspe ctives in research, in particular in relation to short-term blood pres sure variability.