Ambulatory blood pressure monitoring and "white coat" hypertension: saving costs

Appropriate use of ambulatory blood pressure monitoring can be cost effective

The rationale for the use of ambulatory blood pressure monitoring (ABPM) has been the subject of critical reviews and published guidelines.1-6 Perhaps the most important and challenging finding to emerge from ambulatory blood pressure research has been the detection of "white coat" hypertension (also known as isolated clinic hypertension) in about 20% of subjects with repeatedly elevated casual blood pressure readings taken in the doctor's clinic.7,8 The condition can only be detected by ABPM or self-monitoring, and there are no specific predisposing factors. For people with white coat hypertension and no evidence of cardiovascular disease or comorbidities such as diabetes or renal disease, most experts agree that the best policy is to monitor their clinic blood pressure regularly, with self-monitoring at home, and repeat ABPM at one- to two-yearly intervals.