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(Hypertension. 2005;46:25.)
© 2005 American Heart Association, Inc.

Editorial Commentaries

How Can We Use the Results of Ambulatory Blood Pressure Monitoring in Clinical Practice?

Paolo Verdecchia; Fabio Angeli

From the Ospedale R. Silvestrini, Dipartimento Malattie Cardiovascolari, Perugia, Italy.

Correspondence to Dr Paolo Verdecchia, Ospedale R. Silvestrini, Dipartimento Malattie Cardiovascolari, 06100 Perugia, Italy. E-mail verdec@tin.it

An extract of the first 250 words of the full text is provided, because this article has no abstract.

	Introduction

 
After the landmark study by Perloff et al,¹ other investigations showed that ambulatory blood pressure (ABP) is superior to office blood pressure (BP) for cardiovascular risk stratification in untreated and treated hypertensive subjects.^2,3 Also as a consequence of these outcome-based studies, Medicare and Medicaid approved limited and partial ABP monitoring for reimbursement in patients with suspected white coat hypertension (WCH), considering the technique necessary to determine the appropriate management of the patient.

In this issue of Hypertension,⁴ Dolan et al extend the current database on the prognostic value of ABP in hypertensive subjects with the results of the Dublin Outcome Study, a large observational registry of subjects who underwent ABP before treatment and were subsequently followed-up for up to 20 years. Most of these subjects had elevated office BP at entry. During the follow-up period there were 646 deaths, 389 of which were caused by cardiovascular causes, and this huge number provided the opportunity to examine for the first time the value of ABP for prediction of cardiovascular mortality in a large population. After correction for other risk factors, ABP was superior to office BP for prediction of cardiovascular mortality and nighttime ABP was the most potent ABP component for prediction of outcome.

	How to Use ABP Data in the Clinical Practice?

 
The clinical use of ABP in individual subjects to optimize their management is not so simple and immediate. On one hand, the traditional measurement of BP in the doctor’s office will continue to mark the starting point for our clinical decisions because the available evidence on . . . [Full Text of this Article]

Related Article:

Superiority of Ambulatory Over Clinic Blood Pressure Measurement in Predicting Mortality: The Dublin Outcome Study

Eamon Dolan, Alice Stanton, Lut Thijs, Kareem Hinedi, Neil Atkins, Sean McClory, Elly Den Hond, Patricia McCormack, Jan A. Staessen, and Eoin O’Brien
Hypertension 2005 46: 156-161. [Abstract] [Full Text] [PDF]

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