The role of ambulatory BP monitoring in clinical care.

Hypertension (HTN) is a powerful predictor of cardiovascular disease and death, with treatment reducing these risks. Ambulatory BP is a better predictor of target-organ damage and cardiovascular events than office BP (OBP). Clinically, ambulatory BP monitoring (ABPM) can be used to detect white-coat hypertension (WCH) and masked HTN and to more accurately determine whether BP is appropriately controlled in patients with established HTN. This is particularly valuable in the elderly, in whom BP is more variable. ABPM can also identify abnormal circadian rhythm of BP, which is more common in the elderly and is associated with worsened cardiovascular outcomes. ABPM provides diagnostic and prognostic information that is superior to that of casual OBP readings and should be considered in the measurement and management of BP in the elderly.