Twenty-four-hour ambulatory blood pressure monitoring in hypertension: an evidence-based analysis

Health Quality Ontario
Record ID 32012000638
Authors' objectives: The objective of this health technology assessment was to determine the clinical effectiveness and costeffectiveness of 24-hour ambulatory blood pressure monitoring (ABPM) for hypertension.
Authors' recommendations: Limitations of CBPM have led to the need for alternative ways to better manage hypertension. This evidence-based analysis examined whether there is a difference in patient outcome and treatment protocol when using ABPM compared to CBPM for uncomplicated hypertension. Data was abstracted and analyzed in a pooled analysis using Review Manager based on length of study follow-up. A Markov model determined the ICER and a budget impact analysis examined the effect on the Ontario health care system. The quality of evidence was assessed using the GRADE Working Group criteria. A systematic literature search of MEDLINE, EMBASE, CINAHL, Wiley Cochrane, and Centre for Reviews and Dissemination (1997–2011) identified 2,125 citations, where 3 RCTs were included. A 2-fold increased risk for CBPM was shown for total combined cardiovascular events (RR, 1.79; 95% CI, 1.03–3.02) over 5 years. Patients using ABPM were more likely to have control of blood pressure (RR, 1.72; 95% CI, 1.18–2.52) and to discontinue drug therapy (RR, 3.61; 95% CI, 2.11–6.18) in short-term studies. Ambulatory blood pressure monitoring would save the health system $19 million (Cdn) over 5 years, with a borderline dominant effect (ICER: $30 per QALY). The quality of evidence was heterogeneous.
Project Status: Completed
Year Published: 2012
English language abstract: An English language summary is available
Publication Type: Not Assigned
Country: Canada
MeSH Terms
  • Hypertension
Organisation Name: Medical Advisory Secretariat
Contact Address: Medical Advisory Secretariat, 20 Dundas Street West, 10th Floor, Toronto, ON M5G 2N6 CANADA. Tel: 416-314-1092l; Fax: 416-325-2364;
Contact Name:
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Copyright: Medical Advisory Secretariat, Ontario Ministry of Health and Long-Term Care (MAS)
This is a bibliographic record of a published health technology assessment from a member of INAHTA or other HTA producer. No evaluation of the quality of this assessment has been made for the HTA database.