Automated Ambulatory Blood Pressure Devices and Self-Measured Blood Pressure Monitoring Devices: Their Role in the Diagnosis and Management of Hypertension

  1. American College of Physicians.
  1. This guideline was authored by Anne-Marie Audet, MD, and was developed using the information provided in the paper, Automated Ambulatory Blood Pressure Monitoring and Self-Measured Blood Pressure, authored by Lawrence J. Appel and William B. Stason. The guideline was written for the Health and Public Policy Committee by the Clinical Efficacy Assessment Subcommittee: Harold C. Sox, Jr., MD, Chair; Philip M. Gold, MD; Edward J. Huth, MD; Ernest L. Mazzaferri, MD; Albert G. Mulley, Jr., MD; George E. Thibault, MD. Members of the Health and Public Policy Committee were Clifton R. Cleaveland, MD; Chair; Christine K. Cassel, MD; David J. Gullen, MD; Harold C. Sox, Jr., MD; Quentin D. Young, MD; Robert A. Berenson, MD; John M. Eisenberg, MD; Woodrow A. Myers, Jr., MD; Cecil O. Samuelson, Jr., MD; Steven A. Schroeder, MD; Gerald E. Thomson, MD. The clinical guidelines were approved by the Board of Regents on 10 July 1992. Requests for Reprints: Linda Johnson White, Director, Department of Scientific Policy, American College of Physicians, Independence Mall West, Sixth Street at Race, Philadelphia, PA 19106-1572.

    Abstract

    This guideline represents the American College of Physician's policy concerning the use of automated ambulatory blood pressure monitoring devices and self-measured blood pressure monitors in the diagnosis and management of hypertension. It is a technology assessment; a science-based evaluation of two blood pressure measuring devices to supplement or replace traditional office-based physician blood pressure measurements.

    The available evidence does not warrant widespread dissemination or routine use of automated ambulatory blood pressure measurement. On the other hand, we support a more circumspect use of such devices for research and for the care of subgroups of hypertensive patients with specific clinical problems.

    Self-measure blood pressure devices are increasingly being used by patients, and this practice should be encouraged. There has not been sufficient formal evaluation of this method to warrant managing patients solely using blood pressure readings obtained with self-measured blood pressure monitoring devices. We recommend that self-measured blood pressures be used as adjunct to physicians and nonphysicians office-based measurements, and that patients and physicians electing to use these devices be knowledgeable about their optimal use.

    « Previous | Next Article »Table of Contents