Ambulatory blood pressure monitoring: Is it mandatory for blood pressure control in treated hypertensive patients?: Prospective observational study

Abstract Objective Twenty-four hour ambulatory blood pressure (ABP) is superior to office blood pressure (BP) in predicting cardiovascular events. However, its use to optimise BP control in treated hypertensive patients is less well examined. Design and method In this observational study conducted in 899 general practitioners' offices, 4078 hypertensive patients with uncontrolled office BP were included. Antihypertensive therapy was intensified and after 1year office BP and 24-hour ABP were measured to categorise patients according to the ESC/ESH 2007 guidelines. Results In this cohort (mean office BP 156/90mmHg, mean ABP 146/85mmHg), 2059 out of 4078 patients (50.5%) had controlled office BP ( Conclusion In hypertensive patients on therapy, 2 out of 3 with apparently controlled office BP had masked hypertension, suggesting a more aggressive therapy, and 1 out of 8 with elevated office BP had white coat hypertension potentially falsely forcing physicians to intensify therapy. The 3A Registry is listed under clinicaltrials.gov, NCT01454583.