The effective diagnosis and treatment of hypertension by the primary care physician: impact of ambulatory blood pressure monitoring.

BACKGROUND Ambulatory blood pressure monitoring (ABPM) has been described as an effective method for the diagnosis and formulation of the treatment of hypertension by the primary care physician. METHODS Sixty patients selected from a suburban private primary care practice participated in a study that compared measurements of office blood pressures using a mercury sphygmomanometer with the same pressures recorded by ABPM. RESULTS Blood pressures and blood pressure loads measured by ABPM were significantly lower than blood pressures and pressure loads recorded in the office setting. CONCLUSIONS Blood pressure recorded by ABPM differed from the same measurements made by office or casual sphygmomanometry. Use of ABPM changed diagnosis or treatment of hypertension in borderline and antihypertensive drug-treated patients. Ambulatory blood pressure monitoring is a useful tool for the diagnosis and treatment of hypertension by the primary care physician. It can be used to identify white-coat hypertension in various patient populations.