ZDROWIE PIASECZNA
AL. KALIN 55, 05-500 PIASECZNO
przy stadionie K.S. Piaseczno
TEL. 22 750 11 77
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Ambulatory blood pressure monitoring (ABPM)

Ambulatory blood pressure monitoring (ABPM) is a noninvasive method of obtaining blood pressure readings over twenty-four hours, whilst 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. 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, eg 1-hourly).

 

What are the uses of ambulatory blood pressure monitoring?

  • To obtain a twenty-four hour record - more reliable 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, eg left ventricular hypertrophy.
  • To detect white coat hypertension.
  • It has use in hypertension research, eg 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.
  • Episodic dysfunction.
  • Autonomic dysfunction.
  • Hypotensive symptoms whilst on antihypertensive medications.
  • It may be more cost-effective in the long-term.

 

Who should be referred for 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, eg suspected drug resistance.
  • Patients who have developed target organ damage despite control of blood pressure.
  • Patients who develop hypertension during pregnancy.
  • High-risk patients, eg 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, ie blood pressure readings are normal in clinic but raised in the patient's own environment.
  • Postural hypotension.
  • Elderly patients with systolic hypertension.

 

Upper limit of normal ambulatory blood pressure monitoring values

Normal ambulatory BP during the day is <135/<85 and <120/<70 at night.
 Levels above 140/90 during the day, and 125/75 at night should be considered as abnormal.

 

 

 


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