Table 1: Indications, advantages, limitations and instructions for correct use of ambulatory blood pressure monitoring.

Ambulatory blood pressure monitoring

Indications

Advantages

Limitations

Instructions for correct use

-   confirmation of HTN diagnosis in patients with grade I HTN and low/medium cardiovascular risk;

-   suspicion of “white coat HTN”;

-   suspicion of masked HTN;

-   suspicion of hypotension or autonomic nervous system dysfunction;

-   diagnosis of truly drug-resistant HTN;

-   HTN in pregnant women;

-   HTN in patients with glaucoma;

-   measurements are taken in patient’s normal environment;

-   more reliable than office BP values;

-   more measurements, than in the office;

-   may have better predictive value for cardiovascular morbidity and mortality than office measurements;

-   gives information about CBPP;

-   high study costs;

-   low availability;

-   low reproducibility, though higher than standard office measurements;

-   limitations in patients’ compliance;

-   patient may not return the device;

Physicians should:

-   take measurements on both arms and if the difference is < 10 mmHg choose the non-dominant arm, if difference > 10 mmHg - arm with higher values;

-   choose size of the cuff;

-   give instructions to the patient;

Patients should:

-   undertake standard daily activity;

-   limit cardiovascular exercise;

-   stay still and avoid talking during measurements;

-   keep the arm supported during measurement;

-   record relevant daily events;

 

BP: Blood pressure; CBPP: Circadian blood pressure profile; HTN: Hypertension