A study published in Lancet August 2011 showed that ambulatory blood pressure monitoring (ABP) is the most cost-effective method for determining high blood pressure. This is important because most diagnoses of hypertension are based on office-based monitoring (OBH) or home-based monitoring (HBP), both of which are not always accurate, due to daily fluctuations and "white coat" hypertension (elevated BP when in a doctor's office).

COMMENT: Although ABP is the most expensive method up front because it requires the need to carry a monitor that can measure blood pressure at various intervals, it has definite advantages and in the long run is actually cheaper because it eliminates unnecessary treatment. It is also noted that it can measure blood pressure at sleep, which can be indicative of poorer health outcomes (blood pressure should dip at night).

If you have borderline blood pressure, fluctuations or white coat hypertension, you should ask your doctor for ABP monitoring before starting blood pressure medications.