Presse Med
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Recent studies have confirmed that the mean blood pressure levels recorded during ambulatory monitoring are lower than the levels measured by the standard cuff method, possibly due to the "white coat" effect which involves as many as 25 to 30% of the total hypertensive population. In addition, ambulatory blood pressure monitoring is particularly useful to evaluate the day/night cycle. Loss of the normal decrease in blood pressure at night occurs in certain types of secondary hypertension and can be revealed by ambulatory monitoring. ⋯ Ambulatory monitoring can also modify management decisions as found in a recent survey conducted in the United States demonstrating the impact on the treatment of hypertension. For 30 to 40% of the hypertensive patients, therapeutic management was different after ambulatory monitoring than after conventional cuff measurement. Standardization will be the next step in the widespread use of ambulatory blood pressure monitoring.