Ambulatory Blood Pressure Monitoring

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

What does ambulatory blood pressure monitoring involve?

It is well documented 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 a highly accurate automatic blood pressure machine and an arm cuff. The monitor takes blood pressures every 30 minutes during the day and hourly overnight.

What are the uses of ambulatory blood pressure monitoring?

The main benefit of a twenty-four hour record is that it is more reliable than one-off measurements. This technique is currently regarded as the gold standard for diagnosing and treating patients with high blood pressure. It is considered a superior measurement to clinic readings taken in an office or GP surgery setting because it reduces the effect of white coat hypertension. The current guidelines also indicate that structured home blood pressure readings using an appropriate technique and clinically validated equipment is more consistent than clinic readings. Ambulatory blood pressure monitoring (ABPM) is also a very useful technique to identify variable blood pressures and response to treatment.

Who should be referred for ambulatory blood pressure monitoring?

Any patient with a possible diagnosis of high blood pressure, borderline readings in clinic, variable blood pressure readings or where there may be diagnostic uncertainty should be considered for ABPM. Patients in whom there is a suspicion of white coat hypertension are also recommended to undergo a 24 hour ABPM assessment. High risk patients with treated hypertension, eg those with diabetes or previous stroke and patients with signs of end organ disease from hypertension should also be considered for a 24 hour recording to confirm treatment success.