Guidelines on the clinical utility of ambulatory blood pressure.
Ambulatory blood pressure monitoring has made the transition from a technology used almost exclusively in clinical research to one that has numerous applications for clinical practice and the management of hypertension. During the past 8 years, many national working committees have published consensus documents or clinical guidelines on ambulatory blood pressure monitoring in practice. Most of these guidelines, including those published by the American College of Cardiology (1994), the American Society of Hypertension (1996), and the USA's Joint National Committee (1997) support the use of ambulatory blood pressure monitoring for selected patients. Because of increasing evidence that ambulatory blood pressure is an independent risk factor for cardiovascular events, some of the more recent consensus documents have endorsed the more widespread use of ambulatory blood pressure monitoring in clinical practice. However, the growth of ambulatory blood pressure monitoring in practice has generally been limited by the state of the health economy, including lack of reimbursement for the costs of the procedure in most countries.
White
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Section of Hypertension and Clinical Pharmacology, Department of Medicine, University of Connecticut School of Medicine, Farmington, Connecticut, USA.