Controlling blood pressure over 24 hours : a review of the evidence

Despite huge advances in hypertension care in recent times, some important aspects of treatment are not routinely considered in practice, in particular the need for good 24-hour blood pressure (BP) control. Insufficient access to ambulatory blood pressure monitors (ABPM) in primary care and a lack of clear guidance limits routine use in BP management. ABPM, which measures BP over a full 24-hour period and captures BP fluctuations, may provide a more accurate reflection of patients' 'true' BP than traditional office readings. Since uncontrolled 24-hour BP is linked to increased incidence of cardiovascular (CV) events and target organ damage, the panel believed the use of ABPM is beneficial to both patient and doctor. ABPM can aid compliance and guide treatment choices, given that there are marked differences in the duration of action of many commonly used BP treatments. A treatment with a long duration of action may be important in managing BP over 24 hours.