European Society of Hypertension position paper on ambulatory blood pressure monitoring

O’Brien E, Parati G, Stergiou G et al., on behalf of the European Society of Hypertension Working Group on Blood Pressure Monitoring
J Hypertens. 2013 Sep 11. [Epub ahead of print]

Both in clinical practice and in hypertension research, ambulatory blood pressure monitoring (ABPM) is increasingly being used. To date, there is no comprehensive guideline dealing with all aspects of the technique. At a consensus meeting in Milan in 2011 it was agreed that the 34 attendees should prepare such a position paper on the scientific evidence for ABPM.

This position paper not only considers the historical background and the advantages and limitations of ABPM, but also the threshold levels for practice and the cost-effectiveness of the technique.
Different devices and their accuracy are discussed, as well as which additional information and indices can be obtained with ABPM devices.

The paper gives practical guidance on the requirements for using ABPM in clinical practice and how it should be performed,  including in specific circumstances such as obesity and arrhythmias.
Clinical indications for ABPM are broadly discussed, among which white coat phenomena, masked hypertension and nocturnal hypertension. When appropriate, specific considerations are outlined for certain clinical circumstances. The place of home measurement of blood pressure in relation to ABPM is also discussed.

The role of ABPM in research circumstances is examined.
Furthermore, implementation of ABPM in practice is considered in the context of reimbursement situations in different countries, the provision of ABPM by primary care practices, hospital clinics and pharmacies, and the growing role of registries of ABPM in many countries.

Find the ESH position paper on Pubmed