Professor of Medicine & Cardiology
University of Rochester Medical Center
Although the present standard of care for blood pressure management has been in-office blood pressures, there is a growing recognition that masked and white-coat hypertension cannot be accurately diagnoses and adequately treated using that method alone. ABPM provides a profound improvement in this and is recognized as a valuable tool in the most recent ACC/AHA Guideline on Treatment of Hypertension in Adults.
Specifically, ABPM allows for the recognition of people with masked hypertension and allows for proper treatment of them, yielding a benefit to them in heart attack, stroke, and renal protection during their lifetime. Far more people have masked hypertension than was previously realized.
ABPM allows for the recognition of white-coat effect in a large population of people and allows providers to base clinical decisions on the appropriate blood pressure avoiding over-treatment and the associated side effects of that.
The lack of easy reimbursement for ABPM makes it difficult to accurately diagnose and treat these populations and appropriate reimbursement for ABPM would provide a huge public health benefit in the long run and likely be cost-savings as well.