Automated ambulatory blood pressure and self-measured blood pressure monitoring devices: Their role in the diagnosis and management of hypertension

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.