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[Clinical usefulness of non-invasive automatic monitoring of arterial blood pressure].

Recently, new devices for ambulatory blood pressure monitoring have been developed, which have become widely used as highly reliable diagnostic tools. It is now necessary to establish the rationale for their use, and to fully elucidate the diagnostic, prognostic and therapeutic advantages for their use in hypertensive patients. Average 24-hour blood pressure is more closely correlated with the degree of structural cardiovascular alterations than casual blood pressure measurements. Non-invasive blood pressure monitoring therefore seems to be more useful, from a prognostic point of view, than traditional, sphygmomanometric measurement. There is some evidence that ambulatory blood pressure monitoring is more reliable than casual measurements in assessing the efficacy of antihypertensive therapy. From a diagnostic point of view, the significance of blood pressure values obtained with these devices, and the most appropriate index to evaluate the 24-hour blood pressure load remain to be clarified. It is necessary to identify new normal limits for monitored blood pressure values i.e. to establish the baseline level for the start of treatment. At present, due to the lack of widely accepted upper limits of monitored blood pressure, the therapeutic decision should be based on casual blood pressure values, obtained with traditional mercury sphygmomanometer.