What is ABPM
ABPM, also called Ambulatory Blood Pressure Monitoring, is an automated blood pressure measuring device. When applied, it measures Blood pressure at a set interval for a set duration of time. Blood pressure measurement principle is the same as for any other digital/electronic blood pressure measurement device.
What is the Indication of having ABPM
- If your home measured BP is different than Hospital measured BP
- If you feel a significant change in BP in relation to the time of the day or with posture.
- When you need to check the need and efficacy of the medicines for High blood pressure.
- To understand the need for ABPM we need to understand what is blood pressure and what is high blood pressure. I recommend you to have a brief overview of Hypertension written under Health library section.
- When there is the discrepancy between office BP and home, self-measured BP, we find out the reason with ABPM
few of the scenario where 24 Hour ABPM can be of help are:
The most common finding is higher office blood pressure and lower self-measured blood pressure. We call this Whitecoat Hypertension or white coat effect.
The second clinical scenario is when Office BP is lower and self-measured BP is high, we call this Masked Hypertension.
Hypertension patient received 2 or 3 drugs still may have uncontrolled blood pressure. We need to check his blood pressure graph over the 24 hours to make sure control over the whole day and night. This is Resistant Hypertension
Some patients do have the nighttime rise in blood pressure presenting as sleep issues, morning hangover and headaches. To pick up this condition, we need to measure his blood pressure at night time. This is Nocturnal Hypertension.
Patients presenting with a history of fall on getting up with postural dizziness, do have the excessive effect of medicines and cause of fall may be low blood pressure. ABPM will be able to find out this and prevent unnecessary fall.
Patient with Hypertension, shown to have good controlled blood pressure on 24-hour ABPM do have a much better prognosis compared to office measured and managed Hypertension patient.
Patient preparation for ABPM
A technician explains the patient about the machine and how to wear the same. They need to have this machine with them for 24 hours and they need to plan their day accordingly. It is better to continue with a daily routine to have a better understanding of blood pressure response. Wear loose comfortable clothes preferably with a short sleeve or loose sleeve.
Try to use your non-dominant hand for the measurement.
During the ABPM day, the patient should maintain the event log and symptom log.
We inform the patient about the various switches by which they can stop the inflation of bp cuff if it is uncomfortable to them. Few of the patient do find repeated inflation of bp cuff uncomfortable, especially thin and very thick arm persons.
As for self-measured electronic BP measurement device, this device is also electronic. This requires an arm to remain standstill when a measurement is going on.
The patient will come back the next day, the Technician will remove the machine. The technician will extract the data and submit it to the cardiologist. You need to have followed up appointment with your doctor for getting the final report and change in medicines if any according to the report.
If the device is measuring blood pressure repeatedly in succession, it means it has failed to measure blood pressure at first instance and it is trying again. If this happens repeatedly, connect to your technician for help.
Understanding the report of ABPM
The report contains all the measurement of the entire day and night. These data are divided in the daytime and nighttime measurement as the normal range for both differ.
Your doctor will explain to you about the 24 hour average BP, day time and night time average blood pressure. Your cardiologist will discuss the drug efficacy and any need for the change in medicines.
We recommend you to go through our hypertension page in the health library section as well as look for different case scenarios in blog sections
Thanks