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Evidence to Improve Care

Twenty-Four-Hour Ambulatory Blood Pressure Monitoring in Hypertension

Ontario Health Technology Advisory Committee Recommendations

  • Current use of conventional/clinic/office blood pressure monitoring should be optimal and in accordance with established guidelines

  • For diagnosed patients in whom there is clinical suspicion for white coat hypertension (i.e., ongoing discrepancy between in-clinic blood pressure and nonclinic measured blood pressure), 24-hour ambulatory blood pressure monitoring should be made available

Read the full OHTAC Recommendation Report

Achieving accurate blood pressure measurement through conventional/clinic/office monitoring can be challenging because blood pressure may vary naturally throughout the day. Also some individuals with normal everyday blood pressure may exhibit higher blood pressure at the doctor’s office, known as white-coat hypertension, or observers may overemphasize the expected results (known as observer bias).

Health Quality Ontario Reviews 24-Hour Ambulatory Blood Pressure Monitoring

A 24-hour ambulatory blood pressure monitor is a standard inflatable cuff attached to a small computer weighing about 500 grams, which is worn over the shoulder or on a belt. It records an individual’s blood pressure every 15 to 30 minutes during usual daily activities over a 24-hour period. Use of this device can help avoid some of the pitfalls of conventional/clinic/office blood pressure monitoring, such as observer bias and white-coat hypertension.

Twenty-Four-Hour Ambulatory Blood Pressure Monitoring in Hypertension: An Evidence-Based Analysis (PDF)
May 2012

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The Ministry has reviewed this recommendation and in light of new hypertension guidelines has asked Health Quality Ontario to consider prioritizing this topic again.

Health Technology Assessment at Health Quality Ontario

As part of our core function to promote health care supported by the best available evidence, we use established scientific methods to analyze the evidence for a wide range of health interventions, including diagnostic tests, medical devices, interventional and surgical procedures, health care programs and models of care. These analyses are informed by input from a range of individuals, including patients and clinical experts. The Ontario Health Technology Advisory Committee — a committee of the Health Quality Ontario board of directors — reviews the evidence and makes recommendations about whether health care interventions should be publicly funded or not. Draft recommendations are posted on the Health Quality Ontario website for feedback. Final recommendations are approved by our board of directors and then shared with the Ministry of Health and Long-Term Care. For more detailed information, visit our Evidence to Improve Care pages.


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