The study investigated how accurately ambulatory blood pressure monitoring (ABPM) can detect left ventricular enlargement in the Ecuadorian population. The research included 110 adult patients who underwent 24-hour ABPM and cardiac ultrasound from June to October 2022. Left ventricular hypertrophy was present in 34.5% of participants. ABPM parameters showed only a weak ability to distinguish patients with hypertrophy from those without it - the best result was daily systolic pressure with a threshold of ≥ 134 mmHg (sensitivity 45%, specificity 77.8%). The authors conclude that individual ABPM parameters are not sufficiently reliable as independent tools for screening left ventricular hypertrophy. Instead, ABPM should be used as an adjunctive tool for cardiovascular risk assessment along with echocardiography. The suggested cut-off values are considered preliminary and require validation in larger and multicenter studies.