A review of the stability of ambulatory blood pressure: implications for diagnosis of hypertension.
Ambulatory BP monitoring by obtaining many measurements on one day might eliminate the need for multiple visits on different days to diagnose hypertension. However, review of the published literature shows the stability of ambulatory BP as assessed by test-retest correlation between days to be similar to that of office BP in research settings: r = 0.87/0.70 vs 0.79/0.71 (systolic/diastolic). Between-day standard deviations of the difference are also similar: 8/7 mmHg vs 9/7 mmHg, respectively. The reproducibility of within-day fluctuation in BP is poor (r = 0.28/0.11) and may account for some of the difficulty in showing correlations between BP variability and target organ damage. Evidence to date suggests that ambulatory BP monitoring will not reduce observed between-day differences in BP. Diagnosis of elevated BP will require repeated visits whether office or ambulatory BP measurement is employed.
Reeves
R A
RA
Department of Medicine, Sunnybrook Health Science Centre, Toronto, Ontario.
D001795:Blood Pressure Determination / Q000379:methods* / Q000592:standards / Q000706:statistics & numerical data; D015924:Blood Pressure Monitors; D006801:Humans; D006973:Hypertension / Q000175:diagnosis*; D008991:Monitoring, Physiologic