The value of 24-h blood pressure monitoring to assess the efficacy of antihypertensive drug treatment

Ambulatory blood pressure monitoring (ABPM) in pharmacological trials has evolved over the years. It is now evident that its advantages greatly outweigh the limitations arising from BP measurements taken in the clinic. While early studies of antihypertensive drugs were restricted by the need for direct intra-arterial measurement, the development of indirect ambulatory techniques has resulted in more widespread use of ABPM in pharmacological trials. ABPM has demonstrated the BP-lowering efficacy of drugs and BP control, especially in relation to nocturnal hypertension. This review critically evaluates the regulatory recommendations now in place and makes proposals to facilitate the recommendation of the European Medicines Agency for mandatory ABPM in future pharmacological trials of antihypertensive drugs.