lines for self-monitoring of blood pressure (SBPM). We aimed to demonstrate the equivalence of SBPM with ambulatory blood pressure monitoring (ABPM) in the assessment of hypertension. A total of 87 consecutive subjects referred from primary care for standard ABPM underwent a 1-week period of SBPM, as defined by the ESH guidelines, either before or after ABPM. There was no difference in mean blood pressure (BP): SBPM 142/ 87 mm Hg, daytime average ABPM 141/86 mm Hg. The intra-class correlation coefficient was 0.72 and 0.89 for systolic and diastolic pressure, respectively. SBPM is concordant with ABPM in classifying subjects as hypertensive or normotensive in 87% of cases (j ¼ 0.56). The coefficient of variation of SBPM compared with ABPM was 5%. In answer to a direct question 81% of subjects preferred SBPM to ABPM. The current self-monitoring schedule recommended by the ESH, AHA and ASH is valid. The mean BP obtained from SBPM is equivalent to awake-time BP on ABPM, the accepted reference standard for 'out of office' BP measurement. SBPM is simpler to carry out, preferred by patients and should be considered on a par with ABPM.

These findings show that in the long term, nocturnal dip is more stable when expressed as a continuous variable. As recent evidence show cardiovascular risk to be inversely related to nocturnal blood pressure in a continuous manner, surely it makes more sense to express nocturnal dip in a similar way to aid stratification of overall cardiovascular risk.

Background The atherogenic milieu of hypertension, hyperglycaemia and dyslipidaemia results in an excess of cardiovascular deaths in the diabetic population. Objective To determine the efficacy and long-term success of a pharmacist-delivered cardiovascular risk reduction clinic. Methods Patients with diabetes not achieving blood pressure (BP) and lipid targets at a standard diabetes clinic had a mean of four visits to the pharmacist-delivered clinic. Results BP was significantly reduced by attending the clinic (mean reduction in clinic BP 23/10 mmHg). Ambulatory BP monitoring demonstrated a mean reduction of 13/9 mmHg from clinic entry to discharge and this effect was sustained six months post-discharge . Total cholesterol was reduced by 0.4 mmol/L (p=0.002) during clinic attendances and remained unchanged post discharge. Conclusion Patients previously thought to be `resistant' to treatment can have significant reductions in cardiovascular risk factors when enrolled in a short-lived, intense clinic set-up. This is maintained

This study provides evidence to show that observer variance in reporting ABPMs is common even among experts and that computer-generated interpretative reports of ABPM data improve the diagnostic decisions based on the data generated by 24-h blood pressure recording.