Ambulatory Blood Pressure Monitoring-Frequently Asked Questions

What is an ambulatory blood pressure monitor?

Ambulatory blood pressure monitoring (ABPM) is a diagnostic tool designed to monitor the blood pressure (BP) over 24 hours and thus achieve an overall profile of variation in a day. It is a portable test undertaken in the course of a normal day. The test does not cause any pain, however some pressure on the arm may be felt when the cuff is inflating.

How does an ambulatory blood pressure monitor work?

The monitor measures and records blood pressure readings at pre-programmed time intervals. The monitor is equipped with an internal pump to inflate the cuff and all recordings are stored on a memory card.

What are the preparations for the 24-hour ABPM and how long does it take?

A technician will fit the monitor and explain the whole procedure. This takes approximately 10-15 minutes. No special preparations are necessary for the test, but it is sensible to wear a blouse/shirt that is loose on the arms or a short sleeved/sleeveless shirt. You will be asked to fill out a diary indicating your activities over the 24 hour period, so that BP changes can be linked with exercise.

Why do I need 24 hour ambulatory blood pressure monitoring?

There are a number of reasons why we might need this: ✔ To establish a diagnosis of high blood pressure (hypertension) ✔ To identify patients who have higher BP readings when in the clinic ✔ To help decide if BP medication or any change to your medication is required ✔ To further investigate people whose BP is hard to control ✔ To see how well the medicines are controlling BP throughout the day ✔ To see what happens to a patient’s blood pressure at night

What are the benefits of 24 hour ambulatory blood pressure monitoring?

By measuring your BP at regular intervals up to 24 hours, your doctor is able to get a clear idea of how your BP changes throughout the day. Also, because you are able to carry on with your normal routine, it avoids the problems of ‘white coat’ syndrome (where your BP rises because you are feeling anxious about being tested by your doctor/nurse).

What do I need to do during the 24 hour monitoring?

It is important to make sure that the tube to the machine is not twisted or bent to allow the machine to work properly. Also, just before the machine is about to take a reading, it will alert you. When this happens you should:

⚫ Sit down, if possible ⚫ Keep the cuff at the same level as your heart ⚫ Keep your arm still ⚫ Do not talk or cross your legs during the recording
It is recommended that you do not drive for the duration of your monitoring.

Your clinician may ask you to keep a diary whilst wearing the monitor; what time you went to bed and got up and if and when you took medications. Some people find 24-hour testing distracting and uncomfortable. Your clinician should advise you of what to do in this case when they fit the monitor.

How are 24-hour ambulatory blood pressure readings obtained?

BP readings are taken continually over a 24-hour period. You will wear a device around your upper arm that is about the same size as a portable radio. The device is attached to a belt or strap worn on the body. It collects information throughout the 24-hour period that will later be transferred to a computer. The cuff may be worn under clothing so it is not visible. The cuff inflates at certain intervals throughout the day and night. You may be told to keep a diary to record your daily readings that help show how changes in your BP relate to periods of activity or rest. After 24 hours, you can remove the device and BP cuff and return the equipment to your clinic or doctor’s office. A computer analyzes the readings and generates results.

What clothes should I wear before the appointment?

Wear loose clothing, preferably a short sleeved top. The monitor will be fitted underneath your top. You should also wear a belt to which the monitor can be attached

Can I sleep with the monitor on?

Yes, if requested by the doctor or nurse it is important that you keep the monitor on during the night. This will help us understand what your BP is doing whilst you are sleeping.

Can I exercise with the monitor on?

We advise patients to avoid going to the gym/ exercising whilst the monitor is attached. A gentle or brisk walk is fine.

Can I take a bath/shower whilst undergoing monitoring?

Preferably avoid showering or bathing during the period of measurement. If you decide to take a bath or a shower you will need to take off the monitor and cuff as these are not waterproof and you must not get them wet. You need to make sure when reapplying the cuff that it is in the same position as when originally fitted. If you are unsure then ask your nurse/doctor for advice.

While the monitoring is been done, do I need to keep a diary along?

When we analyze the results, we rely on the information you provide in your diary. Sometimes there may be perfectly good reasons as to why your BP was high, for example, when running for a bus. Each time your BP is recorded, you may be asked to make a note of the time and your activity (walking, sitting, smoking etc). You do not need to do this at night, but you must remember to complete the section on the diary which records when you went to sleep and woke up.

Are there other uses for 24-hour ambulatory blood pressure monitoring?

Ambulatory BP monitoring is increasingly being used to determine how well some antihypertensive drugs can control high BP. In some cases, antihypertensive drugs do not control BP effectively throughout the entire day and night. A doctor may need to adjust the dosage prescribed or the time that the medication is given, depending on the patient’s BP patterns. In other cases, more than one drug may be required to stabilize BP.

Ambulatory BP monitoring can also help to predict the likelihood of cardiovascular (blood vessels in the heart) and cerebrovascular (blood vessels in the brain) disease linked to hypertension and organ damage.

Ambulatory BP monitoring may also be suitable in other situations, such as for:

⚫ Pregnant women with hypertension ⚫ Patients with “borderline” hypertension ⚫ Difficulty controlling BP with medication ⚫ BP changes due to other drugs ⚫ Changes in prescription medications that may impact BP ⚫ Hypotension (low BP)

When will I receive the ambulatory blood pressure monitoring results?

Results of the test and a report will be forwarded to your referring doctor within 2 days post the test date. If you have further questions, please speak to your referring doctor.

Is the 24 hour ambulatory blood pressure monitoring safe?

Yes. It is extremely safe and no different than carrying around a small tape recorder for 24 hours. Some people feel a little sore from the frequent pressure checks. Some people get a rash, but it usually goes away without treatment.

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