Importance of ambulatory blood pressure in hypertension management

Geoffrey A Head, Barry P McGrath, Mark R Nelson and Michael Stowasser
Med J Aust 2012; 197 (3): . || doi: 10.5694/mja11.11637
Published online: 6 August 2012

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

  • Geoffrey A Head1
  • Barry P McGrath2
  • Mark R Nelson3
  • Michael Stowasser4

  • 1 Department of Neuropharmacology, Baker IDI Heart and Diabetes Institute, Melbourne, VIC.
  • 2 Monash University and Southern Health, Melbourne, VIC.
  • 3 University of Tasmania, Hobart, TAS.
  • 4 School of Medicine, University of Queensland, Brisbane, QLD.


Competing interests:

Barry McGrath has participated in trials of new pharmaceutical agents, sponsored by Bristol-Myers Squibb, Johnson and Johnson Pharmaceutical Research and Development USA, Novartis Pharmaceuticals Australia, Pfizer Australia and Servier International. He has recently served or is serving on advisory boards for Abbott Australia, AstraZeneca Australia, Boehringer Ingelheim Australia and Solvay Pharmaceuticals. He has received conference travel support from Boehringer Ingelheim Australia. Mark Nelson has participated in trials that have received funding from SmithKline Beecham, AstraZeneca, Bayer, Sanofi-Aventis, Merck Sharpe and Dohme, Pfizer, Servier Laboratories and Bristol-Myers Squibb. He has served on advisory boards for Sanofi-Aventis, Novartis, Schering-Plough and Solvay Pharmaceuticals, and has prepared educational material for Servier Laboratories, AstraZeneca and Bristol-Myers Squibb. He has also received conference and travel support from Bayer HealthCare AG, Merck Sharpe and Dohme, Novartis and Sanofi-Aventis.


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