Advice from the BP Measurement Experts
Most hypertension opinion leaders regard ambulatory blood pressure monitoring as the gold standard for risk assessment since it is superior to both clinic and home BP measurement ,. Ambulatory blood pressure monitoring (ABPM) is a 24 hour blood pressure test in which readings are taken every 15-30 min during the day and 20-60 min during asleep hours. To learn more about ABPM, please, check out this ABPM video.
ABPM provides information which home BP and clinic BP cannot including:
More benefits to ABPM are summarized in the table below.
Benefits of Ambulatory Blood Pressure Monitoring over Home BP and Office BP 
|Mean (true blood pressure)
| Masked hypertension
|Diurnal blood pressure rhythm||Yes||No||No|
| Dipping status
| Morning surge
| Blood pressure variability
| Duration effects of BP meds
You can see from the table above that there are several key benefits to ABPM, but you may not know why they are important. I'll highlight a few on the list.
Most people are familiar with the 140/90 mmHg guidelines for blood pressure. Blood pressure guidelines for ambulatory monitoring are a little lower. The American Heart Association recommends an overall 24-hr average of 130/80 or lower. The 7th Joint National Committee states that awake ambulatory bp measurements should be below 135/85 and asleep measurements should be below 120/75. The European Society of Hypertension (ESH) states that normal awake bp is 135/85, but optimal awake 130/80. The ESH also recommends that normal asleep bp is 120/70, but optimal asleep 115/65.
If you have any questions or comments regarding your experiences with ABPM, we'd love to hear about it!
Back to Part 1 of "The Importance of Ambulatory Blood Pressure Monitoring"
 World Health Organization. (2003). 2003 World Health Organization (WHO)/ International Society of Hypertension (ISH) statement on the management of hypertension. Journal of Hypertension, 21, 1983-1992.
 American Heart Association Statistics Committee and Stroke Statistics Committee. (2009). Circulation, 119, e21 - e181.
 Pickering, TG, Shimbo, D, and Haas, D. (2006). Ambulatory Blood-Pressure Monitoring. New England Journal of Medicine, 354, 2368-2374.
 Urbina, E. et al. (2008). Ambulatory Blood Pressure Monitoring in Children and Adolescents: Recommendations for Standard Assessment. A Scientific Statement from the American Heart Association Arthrosclerosis, Hypertension, and Obesity in Youth Committee of the Council on Cardiovascular Disease in the Young and the Council for High Blood Pressure Research. Hypertension, 52, 433-451.
 Krakoff, LR. (2006). Cost-Effectiveness of Ambulatory Blood Pressure. Hypertension, 47, 29-34.
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