Skip to main content
SpringerLink
Log in

Ambulatory Monitoring of Blood Pressure: An Overview of Devices, Analyses, and Clinical Utility

  • Chapter
Blood Pressure Monitoring in Cardiovascular Medicine and Therapeutics

Part of the book series: Clinical Hypertension and Vascular Diseases ((CHVD))

Abstract

Ambulatory blood pressure monitoring (ABPM) has been available for more than 40 years, and despite substantial evidence that this diagnostic tool provides a more precise picture of BP status in individual persons, in most countries, clinic BP measurements remain the primary method used for hypertension screening, diagnosis, and management. Ambulatory blood pressure (ABP) monitors have become increasingly popular in clinical practice. The numerous benefits include the avoidance of potential blood pressure measurement errors such as observer bias and terminal digit preference and provision of more comprehensive information on blood pressure behavior than is possible with office or home blood pressure measurement (Cardiol Clin 13(4):479–90, 1995).

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 59.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 79.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 109.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Prisant LM. Ambulatory blood pressure monitoring in the diagnosis of hypertension. Cardiol Clin. 1995;13(4):479–90.

    PubMed  CAS  Google Scholar 

  2. Snyder F, Hobson JA, Morrison DF, Goldfrank F. Changes in respiration, heart rate, and systolic blood pressure in human sleep. J Appl Physiol. 1964;19:417–22.

    PubMed  CAS  Google Scholar 

  3. Kario K, Matsuo T, Kobayashi H, Imiya M, Matsuo M, Shimada K. Nocturnal fall of blood pressure and silent cerebrovascular damage in elderly hypertensive patients. Advanced silent cerebrovascular damage in extreme dippers. Hypertension. 1996;27(1):130–5.

    Article  PubMed  CAS  Google Scholar 

  4. Pickering TG. The clinical significance of diurnal blood pressure variations. Dippers and nondippers. Circulation. 1990;81(2):700–2.

    Article  PubMed  CAS  Google Scholar 

  5. O’Brien E, Sheridan J, O’Malley K. Dippers and non-dippers. Lancet. 1988;2(8607):397.

    Article  PubMed  Google Scholar 

  6. Hany S, Baumgart P, Battig B, Walger P, Vetter W, Vetter H. Diagnostic aspects of 24-hour blood pressure determination. Schweiz Rundsch Med Prax. 1987;76(17):450–4.

    PubMed  CAS  Google Scholar 

  7. Shimada K, Kawamoto A, Matsubayashi K, Nishinaga M, Kimura S, Ozawa T. Diurnal blood pressure variations and silent cerebrovascular damage in elderly patients with hypertension. J Hypertens. 1992;10(8):875–8.

    PubMed  CAS  Google Scholar 

  8. Ohkubo T, Imai Y, Tsuji I, et al. Relation between nocturnal decline in blood pres- sure and mortality. The Ohasama Study. Am J Hypertens. 1997;10(11):1201–7.

    Article  PubMed  CAS  Google Scholar 

  9. Mancia G, Bertinieri G, Grassi G, et al. Effects of blood-pressure measurement by the doctor on patient’s blood pressure and heart rate. Lancet. 1983;2(8352):695–8.

    Article  PubMed  CAS  Google Scholar 

  10. Liu JE, Roman MJ, Pini R, Schwartz JE, Pickering TG, Devereux RB. Cardiac and arterial target organ damage in adults with elevated ambulatory and normal office blood pressure. Ann Intern Med. 1999;131(8):564–72.

    Article  PubMed  CAS  Google Scholar 

  11. Ohkubo T, Kikuya M, Metoki H, et al. Prognosis of “masked” hypertension and “white-coat” hypertension detected by 24-h ambulatory blood pressure monitoring 10-year follow-up from the Ohasama study. J Am Coll Cardiol. 2005;46(3):508–15.

    Article  PubMed  Google Scholar 

  12. Head GA, McGarth BP, Mihailidou AS, Nelson MR, Schlaich MP, Stowasser M, Mangoni AA, Cowley D, Brown MA, Ruta LA, Wilson A. Ambulatory blood pressure monitoring in Australia: 2011 consensus position statement. J Hypertens. 2012;30:253–66.

    Article  PubMed  CAS  Google Scholar 

  13. White WB, Schulman P, McCabe EJ, Nardone MB. Clinical validation of the accutracker, a novel ambulatory blood pressure monitor using R-wave gating for Korotkoff sounds. J Clin Hypertens. 1987;3(4):500–9.

    PubMed  CAS  Google Scholar 

  14. Anwar YA, Giacco S, McCabe EJ, Tendler BE, White WB. Evaluation of the efficacy of the Omron HEM-737 IntelliSense device for use on adults according to the recommendations of the Association for the Advancement of Medical Instrumentation. Blood Press Monit. 1998;3(4):261–5.

    PubMed  Google Scholar 

  15. O’Brien E, et al. European Society of Hypertension Position Paper on Ambulatory Blood Pressure Monitoring. J Hypertens. 2013;31:1731–68.

    PubMed  Google Scholar 

  16. White WB, Lund-Johansen P, Omvik P. Assessment of four ambulatory blood pressure monitors and measurements by clinicians vs intraarterial blood pressure at rest and during exercise. Am J Cardiol. 1990;65(1):60–6.

    Article  PubMed  CAS  Google Scholar 

  17. Devereux RB, Pickering TG, Harshfield GA, et al. Left ventricular hypertrophy in patients with hypertension: importance of blood pressure response to regularly recurring stress. Circulation. 1983;68(3):470–6.

    Article  PubMed  CAS  Google Scholar 

  18. Association for the Advancement of Medical Instrumentation, A.V. American National Standard for Electronic or Automated Sphygmomanometers, in ANSI/AAMI SP10-1987. Arlington: AAMI.

    Google Scholar 

  19. O’Brien E, Petrie J, Littler W, et al. The British Hypertension Society protocol for the evaluation of automated and semi-automated blood pressure measuring devices with special reference to ambulatory systems. J Hypertens. 1990;8(7):607–19.

    Article  PubMed  Google Scholar 

  20. White WB, Berson AS, Robbins C, et al. National standard for measurement of resting and ambulatory blood pressures with automated sphygmomanometers. Hypertension. 1993;21(4):504–9.

    Article  PubMed  CAS  Google Scholar 

  21. O’Brien E, Petrie J, Littler W, et al. An outline of the revised British Hypertension Society protocol for the evaluation of blood pressure measuring devices. J Hypertens. 1993;11(6):677–9.

    Article  PubMed  Google Scholar 

  22. O’Brien E, Pickering T, Asmar R, et al. Working Group on Blood Pressure Monitoring of the European Society of Hypertension International Protocol for validation of blood pressure measuring devices in adults. Blood Press Monit. 2002;7(1):3–17.

    Article  PubMed  Google Scholar 

  23. Campbell NR, McKay DW. Do we need another protocol for assessing the validity of blood pressure measuring devices? Blood Press Monit. 2002;7(1):1–2.

    Article  PubMed  Google Scholar 

  24. O’Brien E, Atkins N, Stergiou G, Karpettas N, Parati G, Asmar R, Working Group on Blood Pressure Monitoring of the European Society of Hypertension, et al. European Society of Hypertension International Protocol revision 2010 for the validation of blood pressure measuring devices in adults. Blood Press Monit. 2010;15:23–38.

    Article  PubMed  Google Scholar 

  25. O’Brien E, et al. European Society of Hypertension International Protocol revision 2010 for the validation of blood pressure measuring devices. Blood Press Monit. 2010;15(1):23–38.

    Article  PubMed  Google Scholar 

  26. Stergiou GS, Karpettas N, Atkins N, O’Brien E. Impact of applying the more stringent validation criteria of the revised European Society of Hypertension International Protocol 2010 on earlier validation studies. Blood Press Monit. 2011;16:67–73.

    Article  PubMed  Google Scholar 

  27. Hodgkinson JA, Sheppard JP, Heneghan C, Martin U, Mant J, Roberts N, Mcmanus RJ. Accuracy of ambulatory blood pressure monitors: a systematic review of validation studies. J Hypertens. 2013;31:239–50.

    Article  PubMed  CAS  Google Scholar 

  28. Pickering T. Recommendations for the use of home (self) and ambulatory blood pressure monitoring. American Society of Hypertension Ad Hoc Panel. Am J Hypertens. 1996;9(1):1–11.

    Article  PubMed  CAS  Google Scholar 

  29. Kikuya M, Hozawa A, Ohokubo T, Tsuji I, Michimata M, Matsubara M, et al. Prognostic significance of blood pressure and heart rate variabilities: the Ohasama study. Hypertension. 2000;36.

    Google Scholar 

  30. Parati G, Pomidossi G, Albini F, Malaspina D, Mancia G. Relationship of 24-hour blood pressure mean and variability to severity of target-organ damage in hypertension. J Hypertens. 1987;5(1):93–8.

    Article  PubMed  CAS  Google Scholar 

  31. Frattola A, Parati G, Cuspidi C, Albini F, Mancia G. Prognostic value of 24-hour blood pressure variability. J Hypertens. 1993;11(10):1133–7.

    Article  PubMed  CAS  Google Scholar 

  32. White WB, Dey HM, Schulman P. Assessment of the daily blood pressure load as a determinant of cardiac function in patients with mild-to-moderate hypertension. Am Heart J. 1989;118(4):782–95.

    Article  PubMed  CAS  Google Scholar 

  33. White WB. Accuracy and analysis of ambulatory blood pressure monitoring data. Clin Cardiol. 1992;15(5 Suppl 2):II10–3.

    Article  PubMed  CAS  Google Scholar 

  34. Mule G, Nardi E, Andronico G, et al. Relationships between 24 h blood pressure load and target organ damage in patients with mild-to-moderate essential hypertension. Blood Press Monit. 2001;6(3):115–23.

    Article  PubMed  CAS  Google Scholar 

  35. Gorostidi M, Vinyoles E, Banegas JR, Sierra A. Prevalence of white-coat and masked hypertension in national and international registries. Hypertens Res. 2015;38:1–7.

    Article  PubMed  Google Scholar 

  36. Sipahioglu NT, Sipahioglu F. A closer look at white-coat hypertension. World J Methodol. 2014;4(3):144–50.

    Article  PubMed Central  PubMed  Google Scholar 

  37. Cuspidi C, Rescaldani M, Tadic M, Sala C, Grassi G, Mancia G. White-coat hypertension, as defined by ambulatory blood pressure monitoring, and subclinical cardiac organ damage: a meta-analysis. J Hypertens. 2014;32:24–32.

    Google Scholar 

  38. Mancia G, De Backer G, Dominiczak A, Cifkova R, Fargard R, Germano G, et al. Management of Arterial Hypertension of the European Society of Hypertension; European Society of Cardiology: the Task Force for the Management of Arterial Hypertension (ESH) and of the European Society of Cardiology (ESC). J Hypertens. 2007;25.

    Google Scholar 

  39. Chobanian AV, Bakris GL, Black HR, et al. The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure: the JNC 7 report. JAMA. 2003;289(19):2560–72.

    Article  PubMed  CAS  Google Scholar 

  40. James GD, Pickering TG, Yee LS, Harshfield GA, Riva S, Laragh JH. The reproducibility of average ambulatory, home, and clinic pressures. Hypertension. 1988;11(6 Pt 1):545–9.

    Article  PubMed  CAS  Google Scholar 

  41. Fotherby MD, Potter JF. Reproducibility of ambulatory and clinic blood pressure measurements in elderly hypertensive subjects. J Hypertens. 1993;11(5):573–9.

    Article  PubMed  CAS  Google Scholar 

  42. Staessen JA, Thijs L, Clement D, et al. Ambulatory pressure decreases on longterm placebo treatment in older patients with isolated systolic hypertension. J Hypertens. 1994;12(9):1035–9.

    Article  PubMed  CAS  Google Scholar 

  43. Palatini P, Mormino P, Canali C, et al. Factors affecting ambulatory blood pressure reproducibility. Results of the HARVEST Trial. Hypertension and Ambulatory Recording Venetia Study. Hypertension. 1994;23(2):211–6.

    Article  PubMed  CAS  Google Scholar 

  44. Mansoor GA, McCabe EJ, White WB. Long-term reproducibility of ambulatory blood pressure. J Hypertens. 1994;12(6):703–8.

    Article  PubMed  CAS  Google Scholar 

  45. Mochizuki Y, Okutani M, Donfeng Y, et al. Limited reproducibility of circadian variation in blood pressure dippers and nondippers. Am J Hypertens. 1998;11(4 Pt 1):403–9.

    Article  PubMed  CAS  Google Scholar 

  46. Tamura K, Mukaiyama S, Halberg F. Clinical significance of ABPM monitoring for 48h rather than 24h. Statistician. 1990;39:301–6.

    Article  Google Scholar 

  47. Parati F, et al. European Society of Hypertension practice guidelines for ambulatory blood pressure monitoring. J Hypertens. 2014;32(7):1359–66.

    Article  PubMed  CAS  Google Scholar 

  48. Krause T, Lovibond K, Caulfield M, McCormack T, Williams B. Management of hypertension: summary of NICE guidance. BMJ. 2011;343.

    Google Scholar 

  49. Piper MA, Evans CV, Burda BU, Margolis KL, O’Connor E, Whitlock EP. Diagnostic and predictive accuracy of blood pressure screening methods with consideration of rescreening intervals: an updated systematic review for the U.S. Preventative Services Task Force. Ann Intern Med. 2014;162(3):192–204. doi:10.7326/M14-1539.

    Article  Google Scholar 

  50. Pickering TG, James GD, Boddie C, Harshfield GA, Blank S, Laragh JH. How common is white coat hypertension? JAMA. 1988;259(2):225–8.

    Article  PubMed  CAS  Google Scholar 

  51. Verdecchia P, Porcellati C, Schillaci G, et al. Ambulatory blood pressure. An independent predictor of prognosis in essential hypertension. Hypertension. 1994;24(6):793–801.

    Article  PubMed  CAS  Google Scholar 

  52. Verdecchia P, Schillaci G, Borgioni C, Ciucci A, Porcellati C. White-coat hypertension. Lancet. 1996;348(9039):1444–6.

    Article  PubMed  CAS  Google Scholar 

  53. Palatini P, Mormino P, Santonastaso M, et al. Target-organ damage in stage I hypertensive subjects with white coat and sustained hypertension: results from the HARVEST study. Hypertension. 1998;31(1):57–63.

    Article  PubMed  CAS  Google Scholar 

  54. Sega R, Trocino G, Lanzarotti A, et al. Alterations of cardiac structure in patients with isolated office, ambulatory, or home hypertension: data from the general population (Pressione Arteriose Monitorate E Loro Associazioni (PAMELA) Study). Circulation. 2001;104(12):1385–92.

    Article  PubMed  CAS  Google Scholar 

  55. Staessen JA, Byttebier G, Buntinx F, Celis H, O’Brien ET, Fagard R. Antihypertensive treatment based on conventional or ambulatory blood pressure measurement. A randomized controlled trial. Ambulatory Blood Pressure Monitoring and Treatment of Hypertension Investigators. JAMA. 1997;278(13):1065–72.

    Article  PubMed  CAS  Google Scholar 

  56. Mezzetti A, Pierdomenico SD, Costantini F, et al. White-coat resistant hypertension. Am J Hypertens. 1997;10(11):1302–7.

    Article  PubMed  CAS  Google Scholar 

  57. Muxfeldt ES, Bloch KV, Nogueira AR, Salles GF. Twenty-four hour ambulatory blood pressure monitoring pattern of resistant hypertension. Blood Press Monit. 2003;8(5):181–5.

    Article  PubMed  Google Scholar 

  58. Pierdomenico SD, Lapenna D, Bucci A, et al. Cardiovascular outcome in treated hypertensive patients with responder, masked, false resistant, and true resistant hypertension. Am J Hypertens. 2005;18(11):1422–8.

    Article  PubMed  Google Scholar 

  59. Redon J, Campos C, Narciso ML, Rodicio JL, Pascual JM, Ruilope LM. Prognostic value of ambulatory blood pressure monitoring in refractory hypertension: a prospective study. Hypertension. 1998;31(2):712–8.

    Article  PubMed  CAS  Google Scholar 

  60. Gosse P, Ansoborlo P, Lemetayer P, Clementy J. Left ventricular mass is better correlated with arising blood pressure than with office or occasional blood pressure. Am J Hypertens. 1997;10(5 Pt 1):505–10.

    Article  PubMed  CAS  Google Scholar 

  61. Kario K, Pickering TG, Umeda Y, et al. Morning surge in blood pressure as a predictor of silent and clinical cerebrovascular disease in elderly hypertensives: a prospective study. Circulation. 2003;107(10):1401–6.

    Article  PubMed  Google Scholar 

  62. Kent ST, Shimbo D, Huang L, Diaz KM, Viera AJ, Kilgore M, Oparil S, Muntner P. Rates, amounts, and determinants of ambulatory blood pressure monitor claim reimbursement among Medicare beneficiaries. Am Soc Hypertens. 2014;8(12):898–908.

    Article  Google Scholar 

  63. Moser M. Hypertension can be treated effectively without increasing the cost of care. J Hum Hypertens. 1996;10 Suppl 2:533–58.

    PubMed  Google Scholar 

  64. Yarows SA, Khoury S, Sowers JR. Cost effectiveness of 24-hour ambulatory blood pressure monitoring in evaluation and treatment of essential hypertension. Am J Hypertens. 1994;7(5):464–8.

    PubMed  CAS  Google Scholar 

  65. Khoury S, Yarows SA, O’Brien TK, Sowers JR. Ambulatory blood pressure monitoring in a nonacademic setting. Effects of age and sex. Am J Hypertens. 1992;5(9):616–23.

    Article  PubMed  CAS  Google Scholar 

  66. Krakoff LR. Cost-effectiveness of ambulatory blood pressure: a reanalysis. Hypertension. 2006;47(1):29–34.

    Article  PubMed  CAS  Google Scholar 

  67. Pessanha P, Viana M, Ferreira P, Bertoquini S, Polonia J. Diagnostic value and cost-benefit analysis of 24 hours ambulatory blood pressure monitoring in primary care in Portugal. BMC Cardiovascular Disord. 2013;13:57.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Calhoun Cardiology Center, University of Connecticut School of Medicine, 263 Farmington Avenue, Farmington, CT, 06030-3940, USA

    William B. White M.D.

  2. Clinical Research Center, University of Connecticut School of Medicine, CT, Farmington, USA

    Vanessa Barber

Authors
  1. William B. White M.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Vanessa Barber
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to William B. White M.D. .

Editor information

Editors and Affiliations

  1. Calhoun Cardiology Center, University of Connecticut School of Medicine, Farmington, Connecticut, USA

    William B. White

Rights and permissions

Reprints and permissions

Copyright information

© 2016 Springer International Publishing Switzerland

About this chapter

Cite this chapter

White, W.B., Barber, V. (2016). Ambulatory Monitoring of Blood Pressure: An Overview of Devices, Analyses, and Clinical Utility. In: White, W. (eds) Blood Pressure Monitoring in Cardiovascular Medicine and Therapeutics. Clinical Hypertension and Vascular Diseases. Humana Press, Cham. https://doi.org/10.1007/978-3-319-22771-9_4

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-22771-9_4

  • Publisher Name: Humana Press, Cham

  • Print ISBN: 978-3-319-22770-2

  • Online ISBN: 978-3-319-22771-9

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation