24 hour Ambulatory blood pressure monitoring (ABPM)
During the day your heart pumps blood at different rates. It works differently when you are at work and when you are walking and even more differently when you sleep.
The 24 hour ABPM is obtained with a device which allows the measuring of patient’s blood pressure for a whole day, during various activities and also during sleep. In comparison with the traditional method of blood pressure measurement, it provides a more reliable reading and most of all it obtains the BP readings during different activities that the patient performs. It would be otherwise impossible to measure blood pressure during stressful situations at work or during sleep.
The Technique of the test
The 24 hour ABPM test records the patient’s blood pressure for a whole day (24 hours). The patient carries the device that pumps air into the cuff placed on their arm.
The measurement taking is signalised by a short sound. A single beep informs the patient that a measurement will shortly take place. Subsequently the patient should stay still and straighten out their arm on which the cuff is placed. After the blood pressure is taken, the patient can return to his activities.
In case of a failed reading the device will make two sounds to signalise that it will repeat the measurement. In that case the patient should stretch their arm and check whether the cuff has moved from the place indicated by the nurse. If needed the cuff should be moved back to the right place.
Dear Patient! During this test it is important that you remember not to soak the device, this can cause damage and may therefore result in liability to cover the costs of repair or replacement. In order to overcome this obstacle we advise that because the measurements are taken every 15 minutes during the day (during the night every 30 mins.) it is possible to take the device off for a short period of time allowing to have a short bath or take a quick shower. The ABPM device should be taken off after a valid reading and the patient should try to get washed within a few minutes (to be able to place the device on before the next reading is due). After the bath the ABPM device should be put back on in the way indicated by the nurse.
Reporting the results
The patient is given a diary in which they should write down symptoms and events which took place during the test: times of medicine intake (the name and dose should be written down), activities performed by the patient (walking, running, nap during the day, beginning and end of sleep during the night) as well as strong emotional states.
It is important that the patient is aware that the more data is gathered and given to the doctor the more accurate the report and the diagnosis can be.
Indications for the 24 hour ABPM
- to control the effectiveness of high blood pressure treatment
- to establish a diagnosis of night time hypertension (only occurs at night)
- to establish a diagnosis of a ‘white apron’ hypertension (the blood pressure is high due to the stress related to being at the doctors surgery, but otherwise remains normal)
Preparation for the test
The 24 hour ABPM does not require any special preparation apart from basic hygiene.