Hypertension has emerged as a major contributor to deaths from heart disease. What adds to the problem is the silent nature of the condition. It is not unusual to remain undiagnosed for years, to present suddenly with a complication like a heart attack, a stroke or heart failure. This makes the early and "correct" diagnosis of Hypertension far more imperative. The Ambulatory Blood Pressure Monitoring (ABPM) does exactly that and far more.
What is ABPM?
Ambulatory Blood Pressure Monitoring (ABPM) is when your blood pressure is being measured on the go. It is measured over 24 hours as you move around, living your normal daily life, even during the night. It uses a small digital blood pressure machine that is attached to a belt around your body and which is connected to a cuff around your upper arm. It small enough that you can go about your routine and even sleep with it on.
Do I Really need one?
There are a number of reasons why you might need this:
- To establish a diagnosis of high blood pressure (Hypertension)
- To identify patients who have high blood pressure in the clinic ( known as the white coat effect)
- To help decide if blood pressure medications are required.
- To help decide if any change in medications are required.
- To further investigate patients whose blood pressure is hard to control.
- To see how well a patients' blood pressure medication is controlling the pressure throughout the day.
- To identify ' Non-dippers' patients whose blood pressure is higher in the nighttime. These patients are at a higher risk of stroke.
What happens during 24-hour blood pressure monitoring?
The machine is fitted at the hospital outpatients department or the Clinic. A 24-hour blood pressure measurement is just the same as a normal blood pressure check: a digital machine takes your blood pressure by inflating a cuff around your upper arm and then slowly releasing the pressure. The machine is small enough to be worn on a belt on your waist while the cuff stays on your upper arm for the full 24 hours. The machine then takes blood pressure readings at regular intervals throughout the day: usually, every 15-30 minutes during the daytime and 30-60 minutes at night. You will need to keep the monitor on through the night – you could put the machine under the pillow or on the bed while you sleep. Because the test is being carried out to find out what your normal daily blood pressure is, it is important to carry on with your normal routine and do all the things you would normally do. The only things you should avoid doing for the day are swimming and having a bath or shower. At the end of the 24 hours, you can remove the machine and cuff and give it back to the hospital or clinic. The machine will have stored all your readings and these will then be analysed.
What do I need to do during 24-hour blood pressure monitoring?
- Make sure that the tube to the machine is not twisted or bent.
- Just before the machine is about to take a reading, it will beep. When this happens you should sit down, if possible keep the cuff at the same level as your heart, don't cross your legs and keep your arm steady.
- Keep a diary of what you were doing just before the reading was taken, what time you went to bed and got up and if and when you took medications.