Clinic, Home, and Ambulatory Blood Pressure Measurements - Strengths and Weaknesses

(via https://twitter.com/JACCJournals/status/1088104323354185730 )



Clinic Measurements:

• BP measured in a medical setting 

• Patient should be seated, resting quietly with their back supported and feet flat on the floor 

• Associated with cardiovascular outcomes 

• Only method that has been used to guide treatment in large outcome trials 

• Less precise as only 1 or 2 BP measurements typically obtained 

• Many factors affect the accuracy of readings 

• Requires training and frequent re-training of staff 



Home BP Monitoring:

• BP measured while seated at home, resting quietly with back supported and feet flat on the floor 

• BP readings obtained in the morning and evening 

• Strong association with cardiovascular outcomes 

• Detects white coat and masked hypertension 

• Patients may not correctly measure and report their BP 

• Requires patient training and re-training 



Ambulatory BP Monitoring:

• BP measured during routine activities 

• 48 to 72 readings obtained over 24 hours 

• Strong association with cardiovascular outcomes 

• Detects white coat and masked hypertension 

• BP measured at work and at night (i.e., during sleep) 

• Not tolerated by some patients 

• Equipment is not widely available 

• Requires two clinic visits: to set up and return the device 



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