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      Role of Ambulatory and Home Blood Pressure Monitoring in Clinical Practice: A Narrative Review

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          Hypertension, a common cardiovascular disease (CVD) risk factor, is usually diagnosed and treated based on blood pressure readings obtained in the clinic setting. Blood pressure may differ considerably when measured in the clinic versus outside of the clinic setting. Over the past several decades, evidence has accumulated on two approaches for measuring out-of-clinic blood pressure: ambulatory blood pressure monitoring (ABPM) and home blood pressure monitoring (HBPM). Blood pressure measures on ABPM and HBPM each have a stronger association with CVD outcomes than clinic blood pressure. Controversy exists whether ABPM or HBPM is superior for estimating CVD risk, and under what circumstances these methods should be used in clinical practice for assessing out-of-clinic blood pressure. This review describes ABPM and HBPM procedures, the blood pressure phenotypic measures that can be ascertained, and the evidence that supports the use of each approach to measure out-of-clinic blood pressure. This review also describes barriers to the successful implementation of ABPM and HBPM in clinical practice, proposes core competencies for the conduct of these procedures, and highlights important areas for future research.

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          Author and article information

          Ann Intern Med
          Ann. Intern. Med.
          Annals of internal medicine
          4 November 2015
          13 October 2015
          3 November 2015
          03 November 2016
          : 163
          : 9
          : 691-700
          [* ]Department of Medicine, Columbia University Medical Center, New York, NY
          []Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Pennsylvania, PA
          []Department of Epidemiology, University of Alabama at Birmingham, Birmingham, AL
          Author notes
          Corresponding Author: Daichi Shimbo, MD, Columbia University Medical Center, 622 West 168 th Street, PH 9-310, New York, NY 10032, (212) 342-4490, Fax: (646) 304-7003, ds2231@ 123456cumc.columbia.edu

          Current Mailing Addresses for All Authors

          Daichi Shimbo, MD; Columbia University Medical Center; 622 West 168 th Street, PH 9-310, New York, NY 10032

          Marwah Abdalla, MD; Columbia University Medical Center; 622 West 168 th Street, PH 9-320, New York, NY 10032

          Louise Falzon; Columbia University Medical Center; 622 West 168 th Street, PH 9-322, New York, NY 10032

          Raymond R. Townsend, MD; Renal, Electrolyte and Hypertension Division, Perelman School of Medicine at the University of Pennsylvania; 122 Founders Building, 3400 Spruce Street, Philadelphia, PA 19104

          Paul Muntner, PhD; Department of Epidemiology, University of Alabama at Birmingham; 1700 University Boulevard, Suite 450, Birmingham, AL 35294

          PMC4638406 PMC4638406 4638406 nihpa735327


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