Ambulatory blood pressure monitoring. When is it warranted?

Ambulatory blood pressure monitoring allows repetitive and non-invasive measurements to be taken over a 24-hour period or longer in the patient's usual environment. A technically successful recording yields valuable information about circadian blood pressure patterns and the mean, peak, nadir, standard deviation, and variability of both systolic and diastolic blood pressure. Although ambulatory monitoring should not be used in all hypertensive patients, it can aid in the evaluation of specific problems, such as borderline, resistant, and episodic hypertension; transient hypotension; and blood pressure-related target-organ damage. It also helps in assessing the efficacy of anti-hypertensive medications and in conducting longitudinal epidemiologic studies of target-organ damage and cardiovascular events.