European Society of Hypertension practice guidelines for ambulatory blood pressure monitoring

TLDR

ABPM is increasingly used in clinical practice and hypertension research, prompting a 2013 European Society of Hypertension position paper that reviewed all aspects of the technique based on available evidence. This work updates key aspects of ABPM use in daily practice and offers recommendations for its proper application by specialists and general physicians. The article outlines methodological requirements, clinical indications such as white‑coat, masked, and nocturnal hypertension, the relationship to home BP measurement, and the role of ABPM in pharmacological, epidemiological, and clinical research. Implementation of ABPM varies across countries, depending on reimbursement policies and availability in primary care, hospitals, and pharmacies.

Abstract

Given the increasing use of ambulatory blood pressure monitoring (ABPM) in both clinical practice and hypertension research, a group of scientists, participating in the European Society of Hypertension Working Group on blood pressure monitoring and cardiovascular variability, in year 2013 published a comprehensive position paper dealing with all aspects of the technique, based on the available scientific evidence for ABPM. The present work represents an updated schematic summary of the most important aspects related to the use of ABPM in daily practice, and is aimed at providing recommendations for proper use of this technique in a clinical setting by both specialists and practicing physicians. The present article details the requirements and the methodological issues to be addressed for using ABPM in clinical practice, The clinical indications for ABPM suggested by the available studies, among which white-coat phenomena, masked hypertension, and nocturnal hypertension, are outlined in detail, and the place of home measurement of blood pressure in relation to ABPM is discussed. The role of ABPM in pharmacological, epidemiological, and clinical research is also briefly mentioned. Finally, the implementation of ABPM in practice is considered in relation to the situation of different countries with regard to the reimbursement and the availability of ABPM in primary care practices, hospital clinics, and pharmacies.