Insidermedicine In Depth - August 25, 2011

Ambulatory blood pressure monitoring is the most cost effective way to diagnose high blood pressure, according to research published online ahead of print in The Lancet.

Here is some information about ambulatory blood pressure monitoring:

• It involves wearing an automatic blood pressure monitor for 24 hours during which time the machine takes blood pressure readings at regular intervals

• It is considered to be more accurate than taking a single reading because blood pressure normally fluctuates throughout the day and because patient anxiety can sometimes affect blood pressure readings in the doctor's office

• It is also a better indicator of cardiovascular risk than a single blood pressure reading

Researchers from the University of Birmingham conducted a cost-effectiveness analysis of ambulatory blood pressure measurement, home-based blood pressure measurement, and clinic-based blood pressure measurement. To do so, they used a hypothetical population of adults aged 40 or older whose screening blood pressure was greater than 140/90 mm Hg and who had risk factors for cardiovascular disease similar to the general population. Using this hypothetical population, the investigators compared the three measurement options with respect to lifetime costs, quality-adjusted life years, and cost-effectiveness.

Ambulatory blood-pressure monitoring was found to be the most cost-effective option for both men and women of all ages, saving from £56 to £323 ($92 to $531 USD) per patient. This option also resulted in more quality-adjusted life years for individuals aged older than 50 years.

Today's research demonstrates the superiority of ambulatory blood pressure monitoring and as a result England's National Institute for Health and Clinical Excellence has recommended that high blood pressure be diagnosed using this technique.

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Science & Technology

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