CLINICAL-VALUE OF AMBULATORY BLOOD-PRESSURE MONITORING

This report reviews the evidence for and against clinical use of ambul atory blood pressure monitoring (ABPM) on a large scale. Such monitori ng is supported by a number of data, among which is that the end-organ damage associated with hypertension correlates more with 24-h average blood pressure than with clinic blood pressure, the correlation becom ing even closer with addition of blood pressure variability values. Ho wever, the evidence thus far collected is largely cross-sectional, Fur thermore, ABPM devices have limited accuracy and the procedure has a h igh cost. Therefore, while prospective studies on the prognostic value of ambulatory blood pressure are awaited, use of this approach should be restricted to a limited number of clinical circumstances (e.g., id entification of white-coat hypertension) and used only in specialized centers.