Ambulatory blood pressure monitoring in Australia: 2011 consensus position statement

G Head, Barry McGrath, Anastasia Mihailidou, Mark Nelson, Markus Schlaich, Michael Stowasser, Arduino Mangoni, Diane Cowley, Mark Brown, Lee-Anne Ruta, Alison Wilson

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    100 Citations (Scopus)

    Abstract

    Objective: Although most national guidelines for the diagnosis and management of hypertension emphasize that the initiation and modification of blood pressure (BP)-lowering treatment should be related to absolute cardiovascular disease (CVD) risk, there is only limited information on how to incorporate ambulatory BP (ABP) monitoring into this framework. The objective of this initiative is to provide ABP equivalents for BP cut-points for treatment initiation and targets to be included into guidelines. Methods: A critical analysis of the best available evidence from clinical trials and observational studies was undertaken to develop a new consensus statement for ABP monitoring. Results: ABP monitoring has an important place in defining abnormal patterns of BP, particularly white-coat hypertension (including in pregnancy), episodic hypertension, masked hypertension, labile BP and nocturnal or morning hypertension. This consensus statement provides a framework for appropriate inclusion of ABP equivalents for low, moderate and high CVD risk patients. The wider use of ABP monitoring, although justified, is limited by its availability and cost due to the lack of medical subsidy in Australia. However, cost-benefit analysis does suggest a cost-saving in reduced numbers of inappropriate antihypertensive treatments. Conclusion: Although clinic measurement of BP will continue to be useful for screening and management of suspected and true hypertension, ABP monitoring provides considerable added value toward accurate diagnosis and the provision of optimal care in uncomplicated hypertension, as well as for patients with moderate or severe CVD risk.

    Original languageEnglish
    Pages (from-to)253-266
    Number of pages14
    JournalJournal of Hypertension
    Volume30
    Issue number2
    DOIs
    Publication statusPublished - Feb 2012

    Keywords

    • blood pressure
    • cardiovascular risk
    • consensus
    • guidelines
    • masked hypertension
    • white-coat hypertension

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  • Cite this

    Head, G., McGrath, B., Mihailidou, A., Nelson, M., Schlaich, M., Stowasser, M., Mangoni, A., Cowley, D., Brown, M., Ruta, L-A., & Wilson, A. (2012). Ambulatory blood pressure monitoring in Australia: 2011 consensus position statement. Journal of Hypertension, 30(2), 253-266. https://doi.org/10.1097/HJH.0b013e32834de621