Ambulatory Blood Pressure Measurement

1. Ambulatory BP monitoring readings can be used in the diagnosis of hypertension (Grade C). Ambulatory BP monitoring should be considered when an office-induced increase in BP is suspected in treated patients with:
   1. BP that is not below target despite receiving appropriate chronic anti-hypertensive therapy (Grade C);
   2. Symptoms suggestive of hypotension (Grade C); or
   3. Fluctuating office BP readings (Grade D).
2. Ambulatory BP monitoring upper arm devices that have been validated independently using established protocols must be used www.dableducational.org) (Grade D).
3. Therapy adjustment should be considered in patients with a mean 24-hour ambulatory BP monitoring SBP of ≥130 mmHg and/or DBP of ≥80 mmHg, or a mean awake SBP of ≥135 mmHg and/or DBP of ≥85 mmHg (Grade D).
4. The magnitude of changes in nocturnal BP should be taken into account in any decision to prescribe or withhold drug therapy based upon ambulatory BP monitoring (Grade C) because a decrease in nocturnal BP of <10% is associated with increased risk of CV events.