Ambulatory blood pressure monitoring in clinical practice

Ambulatory blood pressure (ABP) monitoring has become increasingly more ava ilable in routine clinical practice in Canada. The ABP is more reliable and more reproducible than office readings, and is a better predictor of targe t organ damage. Normal values for ABP have been established using both cros s-sectional and longitudinal outcome data. Abnormal mean 24 h and awake ABP values should exceed 135/85 mmHg and 140/90 mmHg, respectively. ABP record ings are useful in making a diagnosis of hypertension by identifying people with high office but normal ABP values. ABP monitoring can also be perform ed in patients already receiving antihypertensive therapy to determine the extent of any white coat effect that may be increasing office readings. The interpretation of the ABP should take into account cardiac risk factors, a ny target organ damage that may De present or coexisting conditions such as diabetes mellitus.