One problem associated with the use of ambulatory blood pressure monitoring in clinical practice has been the lack of internationally accepted reference values. Population studies
have been used to define normal ambulatory blood pressure ranges, according to age and sex, and it is now possible to plot 24 hour blood pressures for each patient and determine if they fall within these accepted bands. The disadvantage of this method has been that many of the earlier published data were not obtained from population-based samples. Nonetheless,
there are more than 30 cross-sectional studies that have linked ambulatory blood pressure to target organ damage using the parameters of left ventricular hypertrophy, icroalbuminuria,
retinal hypertensive changes and cerebrovascular disease. These studies have revealed ambulatory blood pressure to be a more sensitive predictor of target organ damage than single casual measurements, and it has been assumed that these surrogate end points of target organ involvement can be extrapolated to the ultimate end points of cardiac or cerebrovascular death and morbidity.

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