This guideline introduced a number of significant
changes. Essential hypertension, so-called to reflect the understanding
that the elevated pressure was essential to perfuse diseased
arteries, was renamed primary hypertension. Ambulatory
monitoring was introduced as the preferred method of obtaining
serial BP readings to diagnose hypertension, with home BP monitoring
by the patient if ambulatory monitoring is not feasible and
BP readings in the clinic as the least favoured option. Pressures
obtained on ambulatory monitoring reflect the patient’s BP
during everyday activity and are more predictive than clinic
pressures of target organ damage. The prominence given to
ambulatory monitoring in the UK guidelines is in contrast to recommendations
of the recently published 2013 European Society
of Hypertension and European Society of Cardiology Guidelines
which list both home and ambulatory BP monitoring as additional
tests that may be used if appropriate.2