Table 1 Recommendations for conducting ABPM and HBPM in the 2017 American College of Cardiology/American Heart Association BP Guideline

From: Status of ambulatory blood pressure monitoring and home blood pressure monitoring for the diagnosis and management of hypertension in the US: an up-to-date review

Out-of-office BP measurements are recommended to confirm the diagnosis of hypertension and for the titration of antihypertensive medication in conjunction with telehealth counseling or clinical interventions.

COR I and LOE ASR

In adults with an untreated systolic BP > 130 mmHg but <160 mm Hg or diastolic BP > 80 mm Hg but <100 mm Hg, it is reasonable to screen for the presence of white-coat hypertension by using either daytime ABPM or HBPM before the diagnosis of hypertension is made.

COR IIa and LOE B-NR

In adults with white-coat hypertension, periodic monitoring with either ABPM or HBPM is reasonable to detect the transition to sustained hypertension.

COR IIa and LOE C-LD

In adults being treated for hypertension with office BP readings, not at goal and HBPM readings suggestive of a significant white coat effect, confirmation by ABPM can be useful.

COR IIa and LOE C-LD

In adults with untreated office, BPs that are consistently between 120 mm Hg and 129 mm Hg systolic or between 75 mm Hg and 79 mm Hg for DBP, screening for masked hypertension with HBPM (or ABPM) is reasonable.

COR IIa and LOE B–NR

In adults on multiple-drug therapies for hypertension and office BPs within 10 mm Hg above goal, it may be reasonable to screen for white coat effect with HBPM (or ABPM).

COR IIb and LOE C-LD

It may be reasonable to screen for masked uncontrolled hypertension with HBPM in adults being treated for hypertension and office readings at goal, in the presence of target organ damage or increased overall CVD risk.

COR IIb and LOE C-EO

In adults being treated for hypertension with elevated HBPM reading suggestive of masked uncontrolled hypertension, confirmation of the diagnosis by ABPM might be reasonable before intensification of antihypertensive drug treatment.

COR IIb and LOE C-EO

  1. ABPM ambulatory blood pressure monitoring, BP bloodpressure, COR class of recommendation, CVD cardiovascular disease, EO expertopinion, HBPM home blood pressure monitoring, LD limited data, LOE level ofevidence, NR non-randomized data, SR systematic review, COR 1 is recommended, COR IIa is reasonable, COR IIb may be considered, COR III no benefit or possible harm, LOE A high quality evidence, LOE B moderate quality evidence, LOE C-LD limited data, LOE C-EO expert opinion. 
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