# Ambulatory blood pressure monitoring (ABPM)

Intervention · id `cardio:ambulatory-bp-monitoring` · Cardiovascular Atlas · release `2b2017b84496b985` (public)

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Also called: ABPM

Browse, organ or system: Blood vessels  
Browse, condition area: High blood pressure  

## In plain language

Taking repeated blood pressure readings while a person goes about a normal waking day, to check whether a high reading in the clinic is confirmed.

## Technical summary

NICE NG136 recommendation 1.2.3 offers ABPM to confirm a diagnosis of hypertension when clinic blood pressure is between 140/90 and 180/120 mmHg. Recommendation 1.2.6 asks for at least 2 readings an hour across the waking day and uses the average of at least 14 readings. MeSH D018660 is Blood Pressure Monitoring, Ambulatory. The devices used, their accuracy and their validation are outside this record, and so is any use in pregnancy. Recommendations are in the linked claims.

## Claims, with the population each applies to

## Context: Adults with suspected hypertension, clinic blood pressure 140/90 to 180/120 mmHg (NICE NG136 1.2)

Recipient: Adult; Population: Adults aged 18 and over who are assessed for hypertension, with or without type 2 diabetes. Recommendations 1.2.3 and 1.2.4 concern a clinic blood pressure between 140/90 mmHg and 180/120 mmHg. Recommendation 1.2.8 concerns a clinic reading of 140/90 mmHg or higher followed by ambulatory or home monitoring.; Care setting: Clinic measurement first, then ambulatory or home blood pressure monitoring (NICE recommendations 1.2.3, 1.2.4 and 1.2.8); Geography: England, from clause 6 of the NICE terms and conditions, which presents the information as support for people in England who make decisions about funding care. Clause 8 adds that NICE does not write its content as a basis for decisions outside the United Kingdom. The NG136 page itself states no jurisdiction.; Life stage: Adult (aged 18 and over); Follow-up: Not applicable (recommendation context)

### NICE guideline NG136 recommends offering ambulatory blood pressure monitoring (ABPM) to confirm a diagnosis of hypertension in adults whose clinic blood pressure is between 140/90 and 180/120 mmHg.

- Category: Recommendation
- Evidence stage: Guidance
- Certainty: Certainty not assessed
- Applies to: Recipient: Adult; Population: Adults aged 18 and over who are assessed for hypertension, with or without type 2 diabetes. Recommendations 1.2.3 and 1.2.4 concern a clinic blood pressure between 140/90 mmHg and 180/120 mmHg. Recommendation 1.2.8 concerns a clinic reading of 140/90 mmHg or higher followed by ambulatory or home monitoring.; Care setting: Clinic measurement first, then ambulatory or home blood pressure monitoring (NICE recommendations 1.2.3, 1.2.4 and 1.2.8); Geography: England, from clause 6 of the NICE terms and conditions, which presents the information as support for people in England who make decisions about funding care. Clause 8 adds that NICE does not write its content as a basis for decisions outside the United Kingdom. The NG136 page itself states no jurisdiction.; Life stage: Adult (aged 18 and over); Follow-up: Not applicable (recommendation context)
- Limitations: NICE gives no strength label for this recommendation. Its verb is offer. NICE says it uses that verb where the evidence of benefit is strong and leaves little doubt. How NICE applied that convention here was not verified. The NG136 page states no jurisdiction. NICE's terms present the information as support for people in England who make decisions about funding care, and say the content is not written as a basis for decisions outside the United Kingdom. The recommendation carries the year tag 2019, the year of NICE's evidence review. No NICE evidence review was read. A clinic reading of 180/120 mmHg or higher is handled in a separate NICE referral section. This claim records what NICE recommends. It does not say that ABPM is the only or best way to confirm the diagnosis.
- Last checked: 2026-10-11
- Sources:
  1. Supports: Hypertension in adults: diagnosis and management (NICE guideline NG136), Recommendations chapter (Guideline, edition The Recommendations chapter as shown on 2026-10-09 and fetched again on 2026-10-11 with identical bytes. The page header gives 26 February 2026 as the last update. This atlas cites six recommendations from it, each with the version tag the page shows: 1.1.3 is tagged \[2004\]; 1.2.3, 1.2.4 and 1.2.8 are tagged \[2019\]; 1.4.5 is tagged \[2004, amended 2019\]; 1.4.20 is tagged \[2019, amended 2022\]. Which edition of each recommendation these tags point to was not checked.) <https://www.nice.org.uk/guidance/ng136/chapter/Recommendations>
     Locator: Recommendation 1.2.3. Retrieved 2026-10-09T15:59:21Z. Source state: Current. Snapshot hash: 68ce72f3487ffa4715f92ddfa8aaf6e093f5aecd3598cd59a0ab58f74ce86f28.
     How it applies: NICE NG136 as shown on 2026-10-11, last updated 2026-02-26. Offer ABPM to confirm the diagnosis.
  2. Background: Hypertension in adults: diagnosis and management (NICE guideline NG136), Recommendations chapter (Guideline, edition The Recommendations chapter as shown on 2026-10-09 and fetched again on 2026-10-11 with identical bytes. The page header gives 26 February 2026 as the last update. This atlas cites six recommendations from it, each with the version tag the page shows: 1.1.3 is tagged \[2004\]; 1.2.3, 1.2.4 and 1.2.8 are tagged \[2019\]; 1.4.5 is tagged \[2004, amended 2019\]; 1.4.20 is tagged \[2019, amended 2022\]. Which edition of each recommendation these tags point to was not checked.) <https://www.nice.org.uk/guidance/ng136/chapter/Recommendations>
     Locator: Recommendation 1.2.3, version tag at the end. Retrieved 2026-10-09T15:59:21Z. Source state: Current. Snapshot hash: 68ce72f3487ffa4715f92ddfa8aaf6e093f5aecd3598cd59a0ab58f74ce86f28.
     How it applies: Dates the wording of the recommendation.
  3. Background: Hypertension in adults: diagnosis and management (NICE guideline NG136), Recommendations chapter (Guideline, edition The Recommendations chapter as shown on 2026-10-09 and fetched again on 2026-10-11 with identical bytes. The page header gives 26 February 2026 as the last update. This atlas cites six recommendations from it, each with the version tag the page shows: 1.1.3 is tagged \[2004\]; 1.2.3, 1.2.4 and 1.2.8 are tagged \[2019\]; 1.4.5 is tagged \[2004, amended 2019\]; 1.4.20 is tagged \[2019, amended 2022\]. Which edition of each recommendation these tags point to was not checked.) <https://www.nice.org.uk/guidance/ng136/chapter/Recommendations>
     Locator: Recommendations, introductory text, paragraph 3. Retrieved 2026-10-09T15:59:21Z. Source state: Current. Snapshot hash: 68ce72f3487ffa4715f92ddfa8aaf6e093f5aecd3598cd59a0ab58f74ce86f28.
     How it applies: Says the measuring and diagnosing recommendations apply to all adults.
  4. Background: Making decisions using NICE guidelines (Webpage) <https://www.nice.org.uk/about/what-we-do/our-programmes/nice-guidance/nice-guidelines/making-decisions-using-nice-guidelines>
     Locator: Using recommendations, paragraph 2. Retrieved 2026-10-09T15:59:49Z. Source state: Current. Snapshot hash: b7838d1bdb692f2b6dfc71480aa95803d68c64aa0dde406375953c9479aaae7c.
     How it applies: Explains the NICE convention for the word offer. It does not say how the convention applies to this recommendation.
  5. Background: NICE terms and conditions, including the Notice of Rights (Webpage, edition The page as fetched on 2026-10-11. It shows no version date; its footer carries the year 2026.) <https://www.nice.org.uk/terms-and-conditions>
     Locator: Clause 6, sentence 1. Retrieved 2026-10-11T19:11:33Z. Source state: Current. Snapshot hash: 663d4a4be632810ae88513ec6386193a7b373159e5e2ecd4ec61419e2e4c408a.
     How it applies: Source of the England audience read for this claim.
  6. Background: NICE terms and conditions, including the Notice of Rights (Webpage, edition The page as fetched on 2026-10-11. It shows no version date; its footer carries the year 2026.) <https://www.nice.org.uk/terms-and-conditions>
     Locator: Clause 8. Retrieved 2026-10-11T19:11:33Z. Source state: Current. Snapshot hash: 663d4a4be632810ae88513ec6386193a7b373159e5e2ecd4ec61419e2e4c408a.
     How it applies: Source of the United Kingdom reliance limit read for this claim.

## Guidance, authorization and access

### Recommendation `cardio:rec-nice-ng136-1-2-3`

- Intervention: Ambulatory blood pressure monitoring (ABPM) (`cardio:ambulatory-bp-monitoring`)
- Direction: Recommended
- Issued by: National Institute for Health and Care Excellence (`cardio:nice`)
- Guideline: Hypertension in adults: diagnosis and management (NICE guideline NG136), Recommendations chapter, edition The Recommendations chapter as shown on 2026-10-09 and fetched again on 2026-10-11 with identical bytes. The page header gives 26 February 2026 as the last update. This atlas cites six recommendations from it, each with the version tag the page shows: 1.1.3 is tagged \[2004\]; 1.2.3, 1.2.4 and 1.2.8 are tagged \[2019\]; 1.4.5 is tagged \[2004, amended 2019\]; 1.4.20 is tagged \[2019, amended 2022\]. Which edition of each recommendation these tags point to was not checked.; snapshot `cardio:nice-ng136-recs-2026-10-09`
- Jurisdiction: England, from clause 6 of the NICE terms and conditions, which presents the information as support for people in England who make decisions about funding care. Clause 8 adds that NICE does not write its content as a basis for decisions outside the United Kingdom. The NG136 page itself states no jurisdiction.
- Strength: Not labeled on the fetched page. The recommendation uses the verb offer. (NICE wording convention. NICE says it uses the verb offer where the evidence of benefit is strong and leaves little doubt, and the verb consider where the benefit is less certain. How NICE applied this to the recommendation was not verified.)
- Effective: 2019-08-28 (The date NG136 was first published. The recommendation is tagged with 2019, and the page shows a last update of 26 February 2026.)
- Applies to: Recipient: Adult; Population: Adults aged 18 and over who are assessed for hypertension, with or without type 2 diabetes. Recommendations 1.2.3 and 1.2.4 concern a clinic blood pressure between 140/90 mmHg and 180/120 mmHg. Recommendation 1.2.8 concerns a clinic reading of 140/90 mmHg or higher followed by ambulatory or home monitoring.; Care setting: Clinic measurement first, then ambulatory or home blood pressure monitoring (NICE recommendations 1.2.3, 1.2.4 and 1.2.8); Geography: England, from clause 6 of the NICE terms and conditions, which presents the information as support for people in England who make decisions about funding care. Clause 8 adds that NICE does not write its content as a basis for decisions outside the United Kingdom. The NG136 page itself states no jurisdiction.; Life stage: Adult (aged 18 and over); Follow-up: Not applicable (recommendation context)
- Basis: claim `cardio:claim-nice-ng136-1-2-3`

## Connected pages

- NICE NG136 1.2.3: to confirm the diagnosis: Hypertension (high blood pressure) (`core:hypertension`) [a claim, not a settled fact; see claim `cardio:claim-nice-ng136-1-2-3` and its context]
- Measures blood pressure through the waking day: Blood pressure (`core:blood-pressure`)

## Provenance

Content hash: 83158678568690b62aaa39a3e4907dbd216eb0ba928a4876ef70bcea935f9e5c
Last substantive edit: 2026-10-13
Evidence last checked: 2026-10-11