Invited review Blood pressure control based on office and ambulatory blood pressure monitoring: the European experience in hypertensive patients treated in clinical practice

It is currently well documented that blood pressure (BP) should be strictly controlled in hypertensive patients in order to provide optimal protection against cardiovascular and renal complications. The low target BP recommended today (i.e. <140/90 mm Hg in most patients) remains difficult to reach. Actually the BP control rate remains unsatisfactory worldwide. It is more difficult to normalize systolic than diastolic BP, and to control BP in older than in younger patients as well as in patients at high than in those at low cardiovascular risk. Combination antihypertensive therapy is necessary in most patients to normalize BP. Ambulatory BP monitoring is gaining increasing acceptance to detect patients who exhibit normal “out-of-office” BP levels while having still abnormally elevated BP values in the doctor’s office despite ongoing antihypertensive therapy.