Ambulatory Blood Pressure Monitoring in Special Groups

Abstract

The role of ambulatory blood pressure monitoring (ABPM) in hypertension has been recently emphasized in relation to target organ damage. This review shows the importance of ABPM in a special group of patients in order to better select some pathological states. According to the European Society of Hypertension recommendations and not only, we identify the patients who can benefit from ABPM, what the most useful parameters to measure and what goals in terms of ABPM should be achieved. We focus on patients with renal disease, diabetes mellitus, heart failure, sleep apnea syndrome, after heart transplantation, pregnancy and children. Evidence presented in this article demonstrates the high prevalence of a blunted circadian blood pressure profile, its clinical relevance in these patients, and the need to achieve the lowest blood pressure throughout 24-hour in order to prevent both cardiovascular and renal risk. In these special states ABPM can be used because of its prognostic value, as a predictor of complications and also serves as a marker of treatment efficacy.