Ambulatory Blood Pressure Monitoring
What is Ambulatory Blood Pressure Monitoring?
How often will my
blood pressure be taken?
What is Ambulatory Blood Pressure Monitoring?
Ambulatory blood pressure monitoring (ABPM) takes numerous readings of your blood pressure over a 24-hour period or longer. It provides accurate and reliable information and can give you and your doctor a truer picture of your blood pressure than occasional visits and readings taken at your doctor's office.
How often will my
blood pressure be taken?
Usually, your heart rate and blood pressure will be measured at 15 to 30 minute periods during the day and every 30 minutes to one hour at night. Although you may notice the first few times the cuff inflates, you will soon become used to the monitor. Most people find them very easy to wear.
Most ambulatory blood pressure monitors use either what's called an ausculatory method or an oscillomtetric method. Blood pressure sounds are determined by the ausculatory method that uses microphones under the blood pressure cuff. The oscillometric method involves measuring movement of the blood after closing off the brachial artery, the main artery that runs from the shoulder down to the elbow. Some devices use both methods. The data is stored and then interpreted by trained professionals in your doctor's office.
What
does the ambulatory blood pressure monitor look like?
The monitor is a small device worn in a pouch that has a blood pressure cuff attached to it. The cuff is fitted on the patients arm and inflates and deflates automatically throughout the 24- or 48-hour period it is worn.
Will I be able to go
about my normal life?
Wearing a monitor doesn't interfere with daily activities. The monitors are lightweight, comfortable to wear and quiet. Staff in your physician's office will program the device to automatically measure your blood pressure throughout the day and night. You will have an inflatable cuff worn on one arm and a recording device about the size of a Sony Walkman worn at the waist.
Is wearing the monitor
all I have to do?
In combination with monitoring, your doctor may ask you to keep a diary about what time you wake up or go to sleep, when you eat meals, experience strong emotions, stress, take medication, exercise or have other experiences that can affect your blood pressure.
How can
ambulatory blood pressure monitoring help me?
Blood pressure is characterized by a clear circadian rhythm, the natural
24-hour rhythm set by the body's "biological clock." Blood pressure
normally rises in the early morning, varies during the day depending on
activity and falls during sleep.
While blood pressure readings taken occasionally at the doctor's office may be able to signal a problem, ABPM provides a more comprehensive picture of actual blood pressure status. It's also a better predictor of organ damage and heart problems caused by hypertension than standard blood pressure test. This means you and your doctor have solid information to rely on when considering treatment options.
Who
benefits from ambulatory blood pressure monitoring?
ABPM is now a routine procedure in Europe and it is being used
increasingly in the United States to evaluate hypertension and related
conditions such as:
"White Coat" Hypertension - This means that you only have high blood
pressure when you are in the doctor's office. Studies suggest that more
than 20 percent of patients identified as having high blood pressure are
misdiagnosed because they have "White Coat" hypertension. People with
"White Coat" hypertension may be prescribed drug therapy that can be
expensive and have side effects. ABPM takes away the guesswork and gives
a more realistic picture of blood pressure. It can help doctors solve
the diagnostic problem that "White Coat hypertension" presents.
"White Coat" Normotension - About five percent of the population has
"White Coat" normotension. This means that your blood pressure is lower
when it's being taken in the doctor's office, but rises when you leave.
Ambulatory Blood Pressure Monitoring can alert your doctor to the true
state of your blood pressure if you have "White Coat" normotension.
Resistant Hypertension - This is diagnosed when several medications fail
to control high blood pressure as measured in the doctor's clinic or
office. The office reading may not be representative of your blood
pressure over the course of a day. It depends, in part, on the time your
blood pressure is measured in relation to the time your medications are
taken. ABPM will show the degree and duration of medication action in
your body. This will give your doctor valuable information to target
your medications especially for you.
Borderline Hypertension - Sometimes people have high normal blood
pressure readings (a diastolic or bottom number of 85 to 89 mm) in the
doctor's office. But, a closer look reveals that there is damage to the
heart, kidneys or eyes because of the high blood pressure. ABPM can show
higher readings outside of the doctor's office in association with
physical activity, for example, or work-related stress. This may mean
that casual measurements of your blood pressure in your doctor's office
have underestimated the degree of hypertension.
Episodic Hypertension - ABPM can help detect periodic high blood
pressure that indicates another medical problem. ABPM can also help
detect high blood pressure associated with some anxiety syndromes.
Hypertension during Pregnancy - If you have chronic hypertension and become pregnant, your doctor may want to gather more comprehensive information about your blood pressure and may prescribe ABPM. If you're showing signs of toxemia, a kind of high blood pressure that appears after the 20th week of pregnancy in some people, ABPM may be appropriate.
Please consult with your doctor regarding whether or not ABPM is
appropriate for you. It is often recommended for:
individuals whose
home BP is significantly lower than their clinic or office BP (> 10-15
mmHg difference)
individuals whose BP
is difficult to control on multiple blood pressure lowering drugs
individuals who have
symptoms suggesting low BP on antihypertensive therapy
patients who have a history of heart disease and develop symptoms suggesting high BP during those symptoms (e.g., heart failure, headaches, dizziness, etc).