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Advantages of ambulatory BP measurements over office measurements

Prediction of cardiovascular events.

Several studies showed that 24-h ABPM better correlates with cardiovascular outcome than clinic BP levels. In a substudy of the Systolic Hypertension in Europe (Syst-Eur) Trial, Staessen et al. showed that in elderly subjects with untreated isolated systolic HTN, ambulatory systolic BP was a significant predictor of cardiovascular risk over and above clinical BP values. In a prospective cohort study that included 1,464 subjects who were followed for 6.4 years, Ohkubo et al. showed that ambulatory BPs were significantly better related to stroke risk than were screening office BP levels. Recently, Hara et al. showed in 1,007 subjects that 24-h daytime and nighttime ambulatory BP values were closely associated with the risk of silent cerebrovascular lesions detected by brain magnetic resonance imaging, whereas the clinic BP values were not associated with subclinical cerebrovascular events. Of the ambulatory BP values, nighttime BP was the strongest predictor of silent cerebrovascular events.