Automated ambulatory blood pressure monitoring 24 hours

Ambulatory Blood Pressure Monitoring (ABPM), also known as Blood Pressure Holter monitoring, is a method of continuous automatic blood pressure measurement over a 24-hour period or longer during a patient’s normal daily activities.

A blood pressure cuff is placed on the upper arm and connected to a small portable recording device worn on a belt or shoulder strap. The monitor automatically measures blood pressure at scheduled intervals during both daytime and nighttime, storing all readings in the device memory.

The examination allows assessment of:

• blood pressure levels throughout the day and night;
• day-to-night blood pressure fluctuations;
• episodes of elevated or decreased blood pressure;
• effectiveness of antihypertensive treatment;
• blood pressure response to physical activity, stress, sleep, and routine daily activities;
• nocturnal blood pressure reduction;
• masked hypertension;
• “white coat” hypertension.

Indications

24-hour blood pressure monitoring may be recommended in cases of:

• suspected arterial hypertension;
• unstable blood pressure values;
• headaches, dizziness, or weakness;
• fainting or near-fainting episodes;
• palpitations;
• evaluation of antihypertensive therapy effectiveness;
• suspected nocturnal hypertension;
• elevated blood pressure only during clinic visits;
• cardiovascular diseases;
• diabetes mellitus;
• pregnancy with risk of hypertensive complications;
• cardiovascular risk assessment.

Procedure

The examination is performed on an outpatient basis and does not require hospitalization.

During device placement:

• the specialist applies the cuff to the patient’s arm;
• connects the portable monitor;
• programs the device for automatic measurements.

During the monitoring period, the device automatically measures blood pressure:

• usually every 15–30 minutes during the day;
• every 30–60 minutes at night.

Patients may continue their usual daily activities and may be asked to keep a diary of physical activity, sleep, symptoms, and medication intake.

After the monitoring period is completed, the device is removed and the recorded data are analyzed by the physician.

Limitations

During the monitoring period, patients should:

• avoid getting the device or cuff wet;
• avoid bathing or showering;
• avoid intense physical activity;
• protect the device from impacts and excessive vibration;
• keep the arm relaxed and still during measurements whenever possible;
• be aware that repeated cuff inflation, especially at night, may cause temporary discomfort.

Advantages

24-hour ambulatory blood pressure monitoring allows:

• more accurate blood pressure assessment compared to single measurements;
• detection of hidden blood pressure abnormalities;
• evaluation of nighttime blood pressure;
• assessment of treatment effectiveness;
• reduction of misdiagnosis risk;
• individualized therapy adjustment;
• identification of stress- or activity-related blood pressure fluctuations.
   

Sources:

https://cardioscan.co/app/uploads/sites/9/2020/06/US-Mobil-O-Graph_How-to-interpret-ABP-Reports_FA.pdf
https://www.verywellhealth.com/ambulatory-blood-pressure-monitoring-1746062
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7356999/
https://www.ahajournals.org/doi/10.1161/HYPERTENSIONAHA.120.14591
https://my.clevelandclinic.org/health/diagnostics/16330-24-hour-ambulatory-blood-pressure-monitoring
https://www.sozocardiology.com/heart-investigations/24-hour-ambulatory-blood-pressure-abp-monitoring/
https://patient.uwhealth.org/healthfacts/7970