CLINICAL USEFULNESS OF AMBULATORY BLOOD-PRESSURE MONITORING

During the last decade, ambulatory blood pressure monitoring (ABPM) ma de a transition from a method reserved for clinical investigators to a technique considered useful by practicing physicians in assessing cer tain problems in hypertension. Recent recommendations of the National High Blood Pressure Education Program (NHBPEP) Working Group on Ambula tory Blood Pressure Monitoring suggested using ABPM for a number of cl inical problems, including borderline hypertension without target orga n damage, evaluation of drug resistance, and white-coat hypertension. We evaluated the clinical indications for ordering ABPM by Connecticut physicians both in hospital and community-based practices. Through sp ecific questionnaires, the clinical indications used by referring phys icians to order ABPM and their inclinations for future use of the meth odology were assessed. Forty-seven of 70 physicians (65%) responded to the questionnaire, basing their answers on 237 patients. The majority of physicians were internists (57%) or cardiologists (25%). Leading i ndications for patient referral for ABPM included borderline hypertens ion (27%), assessment of drug therapy/BP control (25%), and possible w hite-coat hypertension (22%). Far fewer referrals were observed for se vere hypertension or as a routine test for the diagnosis of hypertensi on. These data suggest that practicing physicians have become aware of the usefulness of ambulatory blood pressure recordings and are follow ing the NHBPEP guidelines on referral for the study.