Table 2.
Ambulatory Blood Pressure Monitoring |
Home Blood Pressure Monitoring |
|
---|---|---|
Appropriate indications | Initial diagnosis and intermittent monitoring of masked hypertension, white coat hypertension, and nocturnal hypertension. | Long-term monitoring and medication titration. |
Measurement frequency and duration | Every 15-30 minutes over a 24-hour period. | Two measurements at least one minute apart in the morning before antihypertensive medications and in the evening before bed. In unstable patients or patients on high risk cancer therapy, measurements should be performed twice daily at minimum once a week (consider daily). In stable patients, measurements should typically be performed for a minimum of 3 (ideally 5-7) consecutive days per month and beginning 7 days after any changes in medication. |
Measurement setting | Performed during usual daily activities and while sleeping. | Performed after resting 3-5 minutes in a quiet room, sitting in a chair with feet flat on the floor and back supported, and with an empty bladder. Patients are asked to avoid caffeine, exercise, and smoking for the 30 minutes prior to measurement. Measure with a bare arm, elevated and supported at the level of the heart. |
Patient engagement | Patient is unaware of and unable to see blood pressure readings. Monitoring may be perceived as intrusive. | Patient activates the device to perform measurements, and sees the blood pressure readings. |
Accessibility | Often only available in hypertension specialty offices (e.g., cardiology, nephrology, hypertension centers) due to cost of monitors. | Low cost, readily accessible to most patients. |
Quality and reliability of measurements | Highly reliable readings, strongly associated with prognostic outcomes. | Highly reproducible readings, require patient training and education to ensure adequate quality. |