Applications of Ambulatory Blood Pressure Monitoring in Behavioral Medicine

The role of behavioral factors in the development of hypertension remains an enigma. To some extent this may be attributable to inadequate techniques for measuring blood pressure. Behavioral research has traditionally relied on two methods— laboratory studies of blood pressure reactivity and epidemiological studies, where a small number of casual blood pressure measurements have been recorded in a clinic or laboratory. Both methods are open to criticism. Blood pressure is continually varying, and at any one moment in time it is highly dependent on the emotional and physical state of the individual. This may result in a major confounding factor for behaviorally-oriented studies. The introduction of non-invasive ambulatory blood pressure monitoring offers an opportunity to overcome these limitations, since large numbers of blood pressure readings can be taken while subjects go about their normal daily activities. Several applications of the technique are possible: (a) it enables the study of the immediate effects of physical and mental activity on blood pressure; (b) one can investigate whether a particular environment has a sustained effect on blood pressure; and (c) the effects of interventions can be assessed.