Ambulatory blood pressure not the answer

Ambulatory monitoring involves taking patient measurements over 24 hours using a portable monitor to more accurately determine blood pressure. In the editorial, “Not much need for ambulatory blood pressure monitoring”, Professor Bruce Neal and Professor Les Irwig said that although this tool offered a more accurate measurement, it was not the best predictor of blood pressure-related diseases.

The authors argued that when deciding which patients to treat, a risk-based patient assessment that also takes into account age, sex, blood lipid levels and presence or absence of smoking and diabetes offered the best guidance.

“However precisely blood pressure is measured, it is unlikely to ever be as good a discriminator as an assessment based on multiple risk factors”, they wrote.

“Compared with traditional hypertension control programs, strategies that allocate blood pressure-lowering treatment based on measures of risk are projected to avert more disease for fewer people treated and at lower cost”.

The authors are calling for the rapid nationwide uptake of an Australian risk assessment tool released by The National Vascular Disease Prevention Alliance that, they say, has the potential to “revolutionise the prevention of blood pressure-related diseases”.

The Medical Journal of Australia is a publication of the Australian Medical Association.

The statements or opinions that are expressed in the MJA reflect the views of the authors and do not represent the official policy of the AMA unless that is so stated.