Relationship Between Outpatient Clinic and Ambulatory Blood Pressure Measurements and Mortality

Abstract

Purpose of review: This review aims to summarize and discuss the relationship between outpatient clinic and ambulatory blood pressure (BP) measurements and cardiovascular morbidity and mortality.

Recent findings: Contemporary clinical practice guidelines worldwide recommend ambulatory blood pressure monitoring (ABPM) to confirm the diagnosis of hypertension. Recent epidemiological studies and systematic reviews showed ABPM predicts cardiovascular events and mortality independent of clinic BP. Ambulatory BP appears to be prognostically superior to clinic BP. ABPM characterizes BP phenotypes that would not have otherwise identified with clinic BP measurement only. Identification of white coat hypertension, which carries a prognosis almost similar to normotension, and masked hypertension, which carries a prognosis almost similar to sustained hypertension, can be accomplished only by ABPM. Randomize controlled trials to assess the cardiovascular effects of hypertensive patients managed with ABPM vs. clinic BP measurement and cost-effective studies of ABPM are warranted.

Keywords: Ambulatory blood pressure monitoring; Cardiovascular diseases; Hypertension; Masked hypertension; Mortality; White coat hypertension.