Importance of average blood pressure measured by 24 hour BP monitoring

Devices for monitoring ambulatory blood pressure are becoming more popular, with more and more hospital acquiring these devices. It can monitor blood pressure at varying preset intervals as specified in the device program. Average daily blood pressure can also be derived from the computer analysis of the recordings. White WB and associates investigated the role of average blood pressure on the progression of cerebrovascular disease and cognitive decline in the elderly [Average Daily Blood Pressure, Not Office Blood Pressure, Is Associated With Progression of Cerebrovascular Disease and Cognitive Decline in Older People. Circulation. 2011; 124: 2312-2319]. They evaluated ambulatory and clinic measured blood pressure, gait studies, magnetic resonance imaging of the brain and neuropsychological tests performed at baseline and at two years follow up. They documented that ambulatory blood pressure correlated with increased white matter hyperintensity volume on T2 weighted imaging, but not the clinic measured blood pressure. Similar correlation was noted with measures of executive function and processing speed of the brain.