Ambulatory Blood Pressure Monitoring

We are happy to mention that facility of “Ambulatory Blood Pressure Monitoring” is available in our hospital.

What is Ambulatory Blood Pressure Monitoring?

ABPM-Ambulatory-Blood-Pressure-Monitor-SystemAmbulatory Blood Pressure Monitoring (ABPM) is a non-invasive method of obtaining blood pressure readings over twenty-four hours, while the patient is in their own environment, representing a true reflection of their blood pressure.
 Many studies have now confirmed that blood pressure measured over a 24-hour period is superior to clinic blood pressure in predicting future cardiovascular events and target organ damage.

What does it involve?

Blood pressure is measured over twenty-four hours using auscultatory or oscillometry and requires use of a cuff. The monitor takes blood pressures every 20 minutes (less frequently overnight, e.g. hourly).

What are the uses of Ambulatory Blood Pressure Monitoring?

  • The main use is to obtain more reliable blood pressure readings than one-off measurements. Studies have shown that increased blood pressure readings on ABPM are more strongly correlated to end-organ damage than one-off measurements, e.g. left ventricular hypertrophy.
  • To detect white coat hypertension.
  • It has use in hypertension research, e.g. reviewing 24-hour profile of antihypertensive medication.
  • It may have prognostic use – higher readings on ABPM are associated with increased mortality.
  • Response to treatment.
  • Masked hypertension.
  • Autonomic dysfunction.
  • Hypotensive symptoms whilst on antihypertensive medications.
  • It may be more cost-effective in the long-term.

Carry on regular activities while on ABPM

Carry on regular activities while on ABPMWho needs Ambulatory Blood Pressure Monitoring?

  • Any patient with persistently raised blood pressure readings or labile blood pressure should be considered for ABPM (whether or not on treatment). However it is not a screening tool.
  • Borderline readings in clinic.
  • Poorly controlled hypertension, e.g. suspected drug resistance.
  • Patients who have developed target organ damage despite control of blood pressure.
  • Patients who develop hypertension during pregnancy.
  • High-risk patients, e.g. those with diabetes mellitus, those with cerebrovascular disease and renal transplant recipients.
  • Suspicion of white coat hypertension – high blood pressure readings in clinic which are normal at home.
  • Suspicion of reversed white coat hypertension, i.e. blood pressure readings are normal in clinic but raised in the patient’s own environment.
  • Postural hypotension.
  • Elderly patients with systolic hypertension.

Dippers and Non-dippers

  • Blood pressure will fall at night in normotensive individuals.
  • In hypertensive patients the blood pressure may fall excessively at night (>10%), leading to describing patients as ‘dippers’, which is associated with a poor outcome.
  • In ‘non-dippers’ the blood pressure remains high, i.e. less than 10% lower than daytime average. This has also been reported to be associated with a poor outcome.