Is home blood pressure monitoring useful?
Home BP monitoring, or ambulatory BP monitoring, is better at predicting cardiovascular events compared to office-based readings. Home BP is documented to improved BP control and patient adherence with medications. It has also been validated against daytime 24-hour ABPM. Therefore home BP should occupy a prominent role in the management of hypertension.
ABPM is used to rule out both white-coat and masked hypertension; BP readings during periods of dizziness or orthostasis can also aid in assessing the contribution of BP to such symptoms.
Wrist-based cuff devices are unreliable, and therefore upper arm (brachial) cuff units are preferred. While many units are available, validation and accuracy are not prerequisites for production; therefore only rigorously tested machines should be purchased. The appropriate technique is like that for ausculatory measurements. Machines should be rechecked annually by measuring pressures against a validated unit.
