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?
Ambulatory 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.
Who 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.
