Opinion - (2025) Volume 14, Issue 1
Received: 01-Feb-2025, Manuscript No. jhoa-25-168491;
, Pre QC No. P-168491;
Reviewed: 15-Feb-2025, QC No. Q-168491;
Revised: 22-Feb-2025, Manuscript No. R-168491;
Published:
28-Feb-2025
, DOI: 10.37421/2167-1095.2024.14.504
Citation: Teixeira, Chien. “Ambulatory Blood Pressure Monitoring in Hypertensive Patients: A Diagnostic Gold Standard?” J Hypertens 14 (2025): 504.
Copyright: © 2025 Teixeira C. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution and reproduction in any medium, provided the original author and source are credited.
A significant advantage of ABPM lies in its ability to uncover BP phenotypes that are frequently missed by office measurements. White-coat hypertension, characterized by elevated BP readings in the clinic but normal readings at home or during daily life, affects up to 30% of patients with elevated office BP. Conversely, masked hypertension normal BP readings in the clinic but elevated values during daily activities may affect 10â??20% of the general population and is associated with an increased risk of cardiovascular events. ABPM identifies these conditions by capturing diurnal BP patterns, thereby preventing both over-treatment and under-treatment. Moreover, ABPM can detect nocturnal hypertension, a powerful predictor of stroke, left ventricular hypertrophy and kidney damage. The presence or absence of a normal nighttime â??dipâ? in BP further refines risk assessment. Compared to office or home BP monitoring, ABPM demonstrates superior sensitivity and specificity, making it a powerful tool in tailoring antihypertensive therapy and guiding clinical decisions [2].
Multiple cohort studies have confirmed the prognostic superiority of ABPM over office-based measurements in predicting long-term cardiovascular outcomes. Elevated 24-hour, daytime and nighttime BP readings obtained via ABPM correlate more strongly with the risk of myocardial infarction, stroke, heart failure and mortality than isolated clinic measurements. ABPM also provides valuable information on BP variability, which has emerged as an independent cardiovascular risk factor. Furthermore, ABPM helps in evaluating treatment efficacy more accurately than clinic BP, capturing sustained BP control throughout the day and identifying possible drug-related hypotensive episodes. In elderly patients, patients with autonomic dysfunction and those with suspected resistant hypertension, ABPM plays a crucial role in therapy adjustment. Given this strong predictive value, major hypertension guidelines including those from the European Society of Hypertension (ESH) and the American Heart Association (AHA) recommend ABPM as the preferred method for confirming the diagnosis of hypertension and assessing treatment response when feasible [3].
Despite its demonstrated accuracy and clinical utility, widespread implementation of ABPM remains inconsistent, especially in primary care and resource-limited settings. While ABPM is endorsed in most clinical guidelines, it is often underutilized due to lack of device availability, cost, limited insurance coverage and unfamiliarity among healthcare providers. In regions with high hypertension prevalence and low health literacy, ABPM may be impractical without adequate infrastructure and patient support. Nonetheless, the increased availability of portable, user-friendly devices has improved its feasibility and some healthcare systems have begun incorporating ABPM into routine diagnostic workflows. ABPM is particularly useful in evaluating treatment-resistant hypertension, assessing response to nocturnal dosing regimens and distinguishing true resistance from poor adherence. Future integration of digital health platforms and remote monitoring tools may enhance the accessibility and affordability of ABPM, especially when linked with electronic health records and mobile-based alerts for real-time feedback [4-5].
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Journal of Hypertension: Open Access received 614 citations as per Google Scholar report