Table 8.

Summary of international guideline recommendations on when to use ambulatory blood pressure monitoring

Guideline	Diagnosis	Treatment monitoring
ESC/ESH (2018)23	Confirm HTN diagnosis if logistically/economically feasible Detect white‐coat HTN in pts with Grade 1 HTN on office BP measurements, or marked office BP elevation without target organ damage Detect masked HTN in pts with high‐normal office BP, or with normal office BP and target organ damage or high cardiovascular risk Evaluate postural and post‐prandial hypotension Evaluate resistant HTN Evaluate exaggerated BP response to exercise For pts with considerable variability in office BP Assessment of nocturnal BP and dipping status Confirm secondary HTN Determine BP during pregnancy, particularly in high‐risk women Screening for HTN in pts with diabetes mellitus	Monitor BP control Evaluation of BP control, especially in treated higher risk pts Evaluate postural and post‐prandial hypotension Confirm inadequate control of BP indicating treatment resistance
AHA/ACC (2017)22	Confirm HTN diagnosis Screen for white‐coat HTN in adults with untreated BP > 130 to <160/>80 to <100 mm Hg Periodic monitoring to detect transition to sustained HTN in pts with white‐coat HTN Screen for masked HTN in individuals with office BP consistently between 120/75 and 129/79 mm Hg	Titration of BP‐lowering medication Confirm white‐coat effect in pts with office BP not at goal and HBPM readings indicative of a significant white‐coat effect Screen for white‐coat effect in pts receiving multiple drug therapies and office BP ≤ 10 mm Hg above goal Confirm masked uncontrolled HTN in treated pts with HBPM readings indicative of masked uncontrolled HTN before intensification of treatment
Taiwan (2015)13	Confirm diagnosis of HTN Identify white‐coat HTN Identify masked HTN Regular monitoring to detect transition to sustained HTN in pts with white‐coat HTN Evaluate diurnal BP changes	Identify white‐coat HTN Detect white‐coat effect
JSH (2014)21	Confirm diagnosis of HTN when there is marked discordance between office BP and home BP In pts with home BP 125‐134/80‐84 mm Hg In pts with high variability in home BP Confirm white‐coat HTN Confirm masked HTN Evaluate dipping status Evaluate short‐term BPV	Evaluate the effects of treatment and duration of treatment effect Identify poorly controlled and treatment‐resistant HTN
Korea (2013)248, 249	Identify white‐coat HTN Identify masked HTN Identify resistant HTN Identify labile HTN Provide accurate BP measurements for risk assessment Assessment of nocturnal BP and dipping status	To assist in the diagnosis of resistant HTN
NICE (2011)16	Confirm diagnosis of HTN when clinic BP is ≥140/90 or HTN is suspected	As an adjunct to clinic BP measurements to monitor the response to antihypertensive treatment

Abbreviations: ABPM, ambulatory blood pressure monitoring; ACC, American College of Cardiology; AHA, American Heart Association; BP, blood pressure; BPV, blood pressure variability; ESC, European Society of Cardiology; ESH, European Society of Hypertension; HBPM, home blood pressure monitoring; HTN, hypertension; JSH, Japanese Society of Hypertension; NICE, National Institute for Health and Care Excellence; pts, patients.