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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.

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