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To the Editor.—The article by Dr Staessen and colleagues¹ emphasizes the importance of considering office hypertension. Twenty-six percent of patients were able to stop taking their antihypertensive medications, and 15% of the entire group of patients who received ambulatory blood pressure (ABP) monitoring were able to avoid medication through the end of the 6-month study and maintain their daytime diastolic blood pressure below 85 mm Hg. In our patient population, we found that the prevalence of patients with normal ABP and elevated office-measured blood pressure was 34%, using 24-hour mean diastolic ABP of less than 85 mm Hg as normal.²

Once hypertension is diagnosed, it is unusual to reevaluate it, and as a result, most patients receive decades of medication therapy. Cost-effectiveness of ABP monitoring depends on the direct cost of ABP monitoring, medication, and office visits, as well as the indirect costs of laboratory monitoring of potential adverse . . . [Full Text of this Article]