Role of ambulatory and home blood pressure recording in clinical practice.

Because of shortcomings of the office blood pressure (BP) measurement in individuals with hypertension (eg, white coat and masked hypertension effects, terminal digit bias, and large variability in BP among a small number of readings), use of out-of-office blood pressure measurements has become more common in clinical practice. The presence of the syndromes of white-coat and masked hypertension creates the concern that the office BP measurements are not reflective of an individual patient's true BP values. Home (or self) and ambulatory BP assessments have been used in numerous types of clinical trials and have demonstrated their usefulness as reliable research and clinical tools. In this article, we review the recent literature on the benefits and limitations of home (self) and ambulatory monitoring of the BP in clinical practice. In particular, how it relates to the diagnosis of patients with various presentations of hypertension and to cardio-vascular outcomes with long-term follow-ups of population cohorts.