OBJECTIVES: Hypertension is a chronic condition, directly linked to cardiovascular diseases. Therefore, the monitoring of blood pressure (BP) is of utmost importance in order to avoid BP-related adverse clinical outcomes. This study aimed at comparing the health resources consumed and the subsequent costs for hypertension management using home blood pressure monitoring alone (HBPM) vs combined office measurements and ambulatory blood pressure monitoring (C/ABPM). METHODS: A total of 116 previously untreated, hypertensive subjects were randomized to use either HBPM or C/ABPM for antihypertensive treatment initiation and titration. The analysis involved all health resources (BP measurements/outpatient visits, laboratory and other tests, pharmaceutical therapy) utilized within 12-months follow up, their respective costs, and efficacy (hypertension control). A 5-year projection was applied assuming (a) continuation of stable treatment as in the end of first year (for both arms), (b) single ABPM/year in C/ABPM group, (c) 2 visits/year in HBPM group and 3 in ABPM. RESULTS: The total cost of hypertension management regardless of BP measurement method was calculated at 1,404.8€/patient (laboratory tests: 50.4%, BP measurements+outpatient visits: 32.4%, pharmaceuticals: 17.1%). In HBPM group, total cost was 1,336.0€/patient vs 1,473.5€/patient in C/ABPM group (p<0.001). Findings suggested that the cost of treatment did not differ between the two groups (233.1 vs 247.6€/patient respectively, p=NS), while BP measurements+outpatient visits were estimated at 393.9€/patient in HBPM arm and 516.9€/patient in C/ABPM arm (p<0.001). For subsequent years (>1), expenditures were estimated at 348.9€/patient for HBPM vs 440.2€/patient for C/ABPM group (p<0.001), whereas for a 5-year projection, 2,731.4€/patient and 3,234.3€/patient respectively (p<0.001). CONCLUSIONS: C/ABPM strategy presented a higher first year cost compared to HBPM, while the same trend was unveiled in 5-year projection. Effective hypertension management through the appropriate strategies is of paramount importance considering its high prevalence; ergo, even small differences in the cost of applying them could have substantial impact on health expenditures.