We have explored the use and interpretation of ambulatory blood pressure monitoring (ABPM) among clinicians at an Edinburgh Cardiovascular Risk Clinic and among a group of international experts in blood pressure monitoring. Locally, we were able to demonstrate major discrepancies in management advice between doctors and nurses. Although all of the international experts used ABPM regularly, they did not agree on thresholds levels for treatment or target BP. This gives food for thought as we consider how to advise internists and primary care physicians on the use and interpretation of ABPM.