International Society of Hypertension

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Evidence-based proposal for the number of ambulatory readings required for assessing blood pressure 

Yang WY, Thijs L, Zhang ZY, Asayama K, Boggia J, Hansen TW, Ohkubo T, Jeppesen J, Stolarz-Skrzypek K, Malyutina S, Casiglia E, Nikitin Y, Li Y, Wang JG, Imai Y, Kawecka-Jaszcz K, O'Brien E, Staessen JA,

International D and on Ambulatory blood pressure in relation to Cardiovascular Outcomes.

Blood Pressure. 2018;27:341-350.

Dr. WY Yang (China)


1.) Summarise your work in one sentence

We assessed the minimal number of ambulatory readings required for assessing blood pressure level in research settings. 

2.) Summarise your findings in one sentence

Among 4277 participants enrolled in the International Database on Ambulatory Blood Pressure in Relation to Cardiovascular Outcomes, 8 awake and 4 asleep or 6 daytime and 3 nighttime readings were sufficient to estimate the ambulatory blood pressure level, diagnose ambulatory hypertension and predict the relative risk of cardiovascular complications. 

3.) Which were the more important methods you used in this work?  If it is not a traditional method, you can briefly explain the concept of that methodology.

We randomly selected a number of readings (from 30 to 1 awake and from 10 to 1 asleep readings) and bootstrapped the analysis 1000 times.  Using complete ambulatory readings as reference, we evaluated: (i) concordance of the ambulatory blood pressure level; (ii) consistency of the cross-classification based on office and ambulatory blood pressure; and (iii) accuracy in predicting cardiovascular complications. 

4.) What did you learn from this paper, what was your take-home message?

24-h ambulatory recordings with ≥8/≥4 awake/asleep or ≥6/≥3 daytime/nighttime readings yielded ABP levels similar to recordings including the guideline-recommended ≥20/≥7 readings.  These criteria save valuable data in a research setting, but are not applicable to clinical practice. 


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