Ambulatory blood pressure measurement in the evaluation of blood pressure lowering drugs.

Since the indirect m e h r e m e n t o f hlood pressure based o n the principle of arterial occlusion using a forearm cuff was introduced by Scipione Kiva-Rocci in 1896 111 and subsequently nlodifiecl t o incorporate auscultation by Nicolai Korotkolf in 1905 (21, this technique h:a been the universal method used in the assessment of blood pressure in medial practice. Most of the evidence showing that the antihypertensive drugs in everyday use lower blood pressure derives from studies of clinic blood pressure measured by this technique 13-51. However, it is well known that casual blood pressure measured in the clinic may be influenced by a number of factors and as long ago as 1904, Theodore Janeway, writing before Korotkoff had reported the now accepted auscultatory method of measuring blood pressure, showed that stress could raise blood pressure 161.