Ambulatory blood-pressure monitoring.

Ambulatory blood pressure monitoring (ABPM) is becoming widely accepted as a clinically useful tool for assessing cardiovascular risk in hypertensive patients, although it is not generally recognized for reimbursement in the United States. There are now six major prospective studies, all of which have shown that ABPM gives a better prediction of risk than conventional clinic measurement. A corollary of these findings is that patients with white coat hypertension have been found to be at relatively low risk. The major clinical indications include patients with newly diagnosed hypertension, suspected white coat hypertension, and refractory hypertension. White coat hypertension is common during pregnancy and may lead to unnecessary cesarean sections.