Application and feasibility of ABPM in the elderly are comparable to y
ounger age groups. The main indications are diagnosis and control of t
reatment in hypertensive patients. Further indications are the diagnos
is of syncope or hypotensive disorders and the diagnostic work-up of s
ymptoms like vertigo, dizziness and dyspnoe. In hypertensives, ABPM ca
n easily assess a white coat effect or cases of white coat hypertensio
n (prevalence in the eldery 15-20%). The prognostic significance of wh
ite coat hypertensions remains to be determined. Determination of circ
adian blood pressure changes with analysis of the 24-hour blood pressu
re profile and the day-night-difference raises the possibility to asse
ss age-related changes. The drop in blood pressure at night (during sl
eep) is usually decreased and less frequently observed in elderly hype
rtensives. So-called ''non-dippers'' with no adequate drop in night-ti
me blood pressure show a significant increase in cardiovascular compli
cations. Control of treatment via ABPM permits the diagnosis of non-re
sponders and overtreatment and the objective analysis of side effects.
Although ABPM improves and frequently facilitates the care of hyperte
nsive patients in the elderly it remains to be determined if it can al
so improve the long-term outcome of these patients.