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(Hypertension. 2009;54:e129.)
© 2009 American Heart Association, Inc.

Letters to the Editor

Response to Home Blood Pressure Measurements Will or Will Not Replace 24-Hour Ambulatory Blood Pressure Measurement

Department of Clinical Medicine and Prevention, University of Milano-Bicocca, Milan, Italy, Department of Cardiology, S Luca Hospital, Istituto Auxologico Italiano, Milan, Italy, Centro Interuniversitario di Fisiologia Clinica e Ipertensione, Milan, Italy

Grzegorz Bilo

Department of Clinical Medicine and Prevention, University of Milano-Bicocca, Milan, Italy, Department of Cardiology, S Luca Hospital, Istituto Auxologico Italiano, Milan, Italy

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

We have read with interest the letter by O'Brien¹ contributing to the debate on the respective role of home blood pressure (BP; HBP) monitoring (HBPM) and ambulatory BP (ABP) monitoring (ABPM) in the clinical management of hypertensive patients.^2,3 We largely agree with O'Brien’s¹ observations, although with a slightly different perspective.

First, we agree that isolated HBP measurements are of limited clinical value. Indeed, only the average of repeated HBP readings carries diagnostic and prognostic information, which may be partly comparable to that provided by 24-hour ABPM,⁴ with most outcome studies being based on structured HBPM schedules including a consistent number of measurements. The recent European guidelines on HBPM recommend that HBP data from 3 (and ideally 7) days of measurements performed twice daily should be used, disregarding the values obtained on the first day.⁴ This task does not appear to be particularly demanding for patients, and it could be made even easier by supplying them with a structured logbook, where HBP values collected during the week preceding each physician’s visit can be stored, or by using automated BP measuring devices equipped with specific software tools able to follow the HBPM schedule recommended by recent guidelines⁴ and providing the average value of the HBPM week after discarding the initial day. It has to be acknowledged that many patients perform HBPM without doctor’s guidance, often measuring their HBP much too frequently. The recent European Society of Hypertension and American Heart Association recommendations on HBPM^4,5 strongly advise HBPM to be performed always under . . . [Full Text of this Article]