Ambulatory blood pressure monitoring (ABPM)

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.

Also called ABPM

Intervention
In this atlas

Overview

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.

About this intervention

Type: Test
Mechanism: Readings are taken repeatedly across the person's normal waking day, and the average of the readings is used (NICE recommendation 1.2.6).

Classification codes

MeSH MeSH linked-data descriptor record fetched on 2026-10-11, lastUpdated 2015-06-22; the record states no yearly MeSH release D018660 Blood Pressure Monitoring, Ambulatory

Claims and evidence

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)

Eligibility: 3 inclusion criteria; 2 exclusion criteria

Included: Adult aged 18 and over (NICE NG136 Overview chapter)
Clinic blood pressure between 140/90 mmHg and 180/120 mmHg (recommendations 1.2.3 and 1.2.4)
With or without type 2 diabetes (introductory text to the NG136 recommendations)
Excluded: Pregnancy is outside this atlas context. NICE has a separate guideline on hypertension in pregnancy, and the fetched diagnosis recommendations state no separate pregnancy exclusion.
A clinic blood pressure of 180/120 mmHg or higher is handled in the NG136 referral section, which this context does not cover.

Recommendation Guidance Certainty not assessed

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.
Applies to Adult
- 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.
- Clinic measurement first, then ambulatory or home blood pressure monitoring (NICE recommendations 1.2.3, 1.2.4 and 1.2.8)
- 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.
- Adult (aged 18 and over)
Follow-up Not applicable (recommendation context)
Certainty method
Not assessed

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

Next evidence check due
Not scheduled
Sources and citations (6)
1. Supports Hypertension in adults: diagnosis and management (NICE guideline NG136), Recommendations chapter
  
  Guideline · National Institute for Health and Care Excellence (NICE) · 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. · Published 2019-08-28 · nice: NG136
  
  Locator
  Recommendation 1.2.3
  
  How it applies
  NICE NG136 as shown on 2026-10-11, last updated 2026-02-26. Offer ABPM to confirm the diagnosis.
  
  Retrieved
  2026-10-09T15:59:21Z
  
  Source effective date
  2026-02-26
  
  Source state
  Current
  
  Snapshot hash
  68ce72f3487ffa4715f92ddfa8aaf6e093f5aecd3598cd59a0ab58f74ce86f28
  
  Reuse basis
  Public text is cite_only (Ben's decision of 2026-10-13 (medical-atlas-core issue 2)): public pages state the facts in the atlas's own words, with a citation and a link, and use no NICE wording. NICE's terms and conditions (source cardio:nice-terms-and-conditions, fetched 2026-10-11) make NICE content available for reuse in the United Kingdom only. Outside the United Kingdom, apart from private use, study or one's own research, reuse needs NICE's prior written agreement, which may carry a licence and a fee, and use for artificial intelligence needs approval and a licensing arrangement. The terms also say NICE does not write its content as a basis for decisions outside the United Kingdom. The page bytes are not committed.
2. Background Hypertension in adults: diagnosis and management (NICE guideline NG136), Recommendations chapter
  
  Guideline · National Institute for Health and Care Excellence (NICE) · 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. · Published 2019-08-28 · nice: NG136
  
  Locator
  Recommendation 1.2.3, version tag at the end
  
  How it applies
  Dates the wording of the recommendation.
  
  Retrieved
  2026-10-09T15:59:21Z
  
  Source effective date
  2026-02-26
  
  Source state
  Current
  
  Snapshot hash
  68ce72f3487ffa4715f92ddfa8aaf6e093f5aecd3598cd59a0ab58f74ce86f28
  
  Reuse basis
  Public text is cite_only (Ben's decision of 2026-10-13 (medical-atlas-core issue 2)): public pages state the facts in the atlas's own words, with a citation and a link, and use no NICE wording. NICE's terms and conditions (source cardio:nice-terms-and-conditions, fetched 2026-10-11) make NICE content available for reuse in the United Kingdom only. Outside the United Kingdom, apart from private use, study or one's own research, reuse needs NICE's prior written agreement, which may carry a licence and a fee, and use for artificial intelligence needs approval and a licensing arrangement. The terms also say NICE does not write its content as a basis for decisions outside the United Kingdom. The page bytes are not committed.
3. Background Hypertension in adults: diagnosis and management (NICE guideline NG136), Recommendations chapter
  
  Guideline · National Institute for Health and Care Excellence (NICE) · 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. · Published 2019-08-28 · nice: NG136
  
  Locator
  Recommendations, introductory text, paragraph 3
  
  How it applies
  Says the measuring and diagnosing recommendations apply to all adults.
  
  Retrieved
  2026-10-09T15:59:21Z
  
  Source effective date
  2026-02-26
  
  Source state
  Current
  
  Snapshot hash
  68ce72f3487ffa4715f92ddfa8aaf6e093f5aecd3598cd59a0ab58f74ce86f28
  
  Reuse basis
  Public text is cite_only (Ben's decision of 2026-10-13 (medical-atlas-core issue 2)): public pages state the facts in the atlas's own words, with a citation and a link, and use no NICE wording. NICE's terms and conditions (source cardio:nice-terms-and-conditions, fetched 2026-10-11) make NICE content available for reuse in the United Kingdom only. Outside the United Kingdom, apart from private use, study or one's own research, reuse needs NICE's prior written agreement, which may carry a licence and a fee, and use for artificial intelligence needs approval and a licensing arrangement. The terms also say NICE does not write its content as a basis for decisions outside the United Kingdom. The page bytes are not committed.
4. Background Making decisions using NICE guidelines
  
  Webpage · National Institute for Health and Care Excellence (NICE)
  
  Locator
  Using recommendations, paragraph 2
  
  How it applies
  Explains the NICE convention for the word offer. It does not say how the convention applies to this recommendation.
  
  Retrieved
  2026-10-09T15:59:49Z
  
  Source effective date
  Not reported
  
  Source state
  Current
  
  Snapshot hash
  b7838d1bdb692f2b6dfc71480aa95803d68c64aa0dde406375953c9479aaae7c
  
  Reuse basis
  Public text is cite_only (Ben's decision of 2026-10-13 (medical-atlas-core issue 2)): public pages state the facts in the atlas's own words, with a citation and a link, and use no NICE wording. NICE's terms and conditions (source cardio:nice-terms-and-conditions, fetched 2026-10-11) make NICE content available for reuse in the United Kingdom only; outside it, apart from private use, study or one's own research, NICE's prior written agreement is needed.
5. Background NICE terms and conditions, including the Notice of Rights
  
  Webpage · National Institute for Health and Care Excellence (NICE) · Edition The page as fetched on 2026-10-11. It shows no version date; its footer carries the year 2026.
  
  Locator
  Clause 6, sentence 1
  
  How it applies
  Source of the England audience read for this claim.
  
  Retrieved
  2026-10-11T19:11:33Z
  
  Source effective date
  Not reported
  
  Source state
  Current
  
  Snapshot hash
  663d4a4be632810ae88513ec6386193a7b373159e5e2ecd4ec61419e2e4c408a
  
  Reuse basis
  Public text is cite_only (Ben's decision of 2026-10-13 (medical-atlas-core issue 2)): public pages state the facts in the atlas's own words, with a citation and a link, and use no NICE wording. This page sets the terms under which NICE content may be reused; its wording is kept in research/cluster-b/quotes.tsv as internal evidence and is not published. The page bytes are not committed.
6. Background NICE terms and conditions, including the Notice of Rights
  
  Webpage · National Institute for Health and Care Excellence (NICE) · Edition The page as fetched on 2026-10-11. It shows no version date; its footer carries the year 2026.
  
  Locator
  Clause 8
  
  How it applies
  Source of the United Kingdom reliance limit read for this claim.
  
  Retrieved
  2026-10-11T19:11:33Z
  
  Source effective date
  Not reported
  
  Source state
  Current
  
  Snapshot hash
  663d4a4be632810ae88513ec6386193a7b373159e5e2ecd4ec61419e2e4c408a
  
  Reuse basis
  Public text is cite_only (Ben's decision of 2026-10-13 (medical-atlas-core issue 2)): public pages state the facts in the atlas's own words, with a citation and a link, and use no NICE wording. This page sets the terms under which NICE content may be reused; its wording is kept in research/cluster-b/quotes.tsv as internal evidence and is not published. The page bytes are not committed.

Guidance

Recommended: Ambulatory blood pressure monitoring (ABPM)

Applies to Adult

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.
Clinic measurement first, then ambulatory or home blood pressure monitoring (NICE recommendations 1.2.3, 1.2.4 and 1.2.8)
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.
Adult (aged 18 and over)

Follow-up Not applicable (recommendation context)

Issued by: National Institute for Health and Care Excellence
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.
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.)
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.

Basis: 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.
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.

Clinical links

Each link reports what one cited claim says about one population. "Evaluated for" means studied, not shown to work. These links do not show that anything is effective or right for you.

Claim, not a settled fact NICE NG136 1.2.3: to confirm the diagnosis: Hypertension (high blood pressure) (Recommended for)
Applies to Adult
- 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.
- Clinic measurement first, then ambulatory or home blood pressure monitoring (NICE recommendations 1.2.3, 1.2.4 and 1.2.8)
- 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.
- 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.
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.

Record details

Record id: cardio:ambulatory-bp-monitoring
Content hash: 83158678568690b62aaa39a3e4907dbd216eb0ba928a4876ef70bcea935f9e5c