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A New Role for Ambulatory Blood Pressure Monitoring?

Thomas G. Pickering, MD, DPhil
JAMA. 1997;278(13):1110. doi:10.1001/jama.1997.03550130084042.
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It has been known for more than 50 years that the blood pressure (BP) of hypertensive patients measured in a medical setting such as a physician's office tends to be higher than in other settings.1 With the introduction of noninvasive ambulatory BP monitoring, researchers showed that about 20% of patients hypertensive in the physician's office have normal BPs outside the office, a phenomenon usually referred to as white coat hypertension.2 Whether such patients should be given antihypertensive medication remains controversial, but most experts believe that the best policy is simply to monitor their BP on a regular basis, both in and out of the office.3 There is also evidence that if patients with white coat hypertension are started on medication, the office BP is reduced but not the BP during the rest of the day.4 Ambulatory monitoring so far has been used in clinical practice principally


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