Ambulatory blood pressure monitoring: recent evidence and clinical pharmacy applications.

Conventional office blood pressure readings are a well-established surrogate for the prediction of cardiovascular risk. It is assumed that these readings reflect an underlying average level of blood pressure exposure occurring in an individual over a period of time. But because blood pressure is not static, important additional prognostic information about the diurnal blood pressure profile, including within-day and between-day variability, is not easily ascertained from conventional measurements. Ambulatory blood pressure monitoring provides a more thorough depiction of the underlying blood pressure level and predicts cardiovascular risk more robustly than do conventional blood pressure measurements. Although the technology has been available for more than 30 years, there has been an expansion of the research base in the past decade supporting its role in the evaluation and management of patients with hypertension and as an important surrogate in research trials. This review summarizes recent evidence supporting the predictive ability of ambulatory blood pressure monitoring and briefly highlights opportunities for clinical pharmacists to adopt this important clinical and research tool.