Ambulatory monitoring is critical in accurately assessing blood pressure to calculate absolute cardiovascular risk
Recently, there has been debate about the need for ambulatory blood pressure monitoring (ABPM) in clinical decision making, promoting instead the use of an absolute cardiovascular disease (CVD) risk-based approach.1 While we fully endorse hypertension management based on absolute risk, inherent in this assessment is the accurate measurement of blood pressure (BP). The available data suggest this can best be achieved by ABPM. Following an exhaustive literature analysis, the new British National Institute for Health and Clinical Excellence guidelines for hypertension2 have recommended that all suspected hypertensive patients require ABPM.3 An issue in Australia is whether there is financial justification for routine use of ABPM for such diagnostic purposes. Evidence strongly supports ABPM as more cost-effective than the repeated clinic measurements required to establish a patient’s true BP.4
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