VIII. Ambulatory Blood Pressure Measurement
1) Ambulatory BP readings can be used in the diagnosis of hypertension (Grade C).
2) ABPM should be considered when an office-induced increase in BP is suspected in treated patients with:
- BP that is not below target despite receiving appropriate chronic antihypertensive therapy (Grade C);
- symptoms suggestive of hypotension (Grade C); or
- fluctuating office BP readings (Grade D).
3) Physicians should use only ABPM devices that have been validated independently using established protocols (Grade D).
4) Therapy adjustment should be considered in patients with 24 h ambulatory SBP of 130 mm Hg or higher and/or DBP of 80 mm Hg or higher and/or awake SBP of 135 mm Hg or higher and/or DBP of 85 mm Hg or higher (Grade D).
5) The magnitude of changes in nocturnal BP should be taken into account in any decision to prescribe or withhold drug therapy based upon ambulatory BP (Grade C) because a decrease in nocturnal BP of less than 10% is associated with increased risk of CV events.