Ambulatory blood pressure monitoring

Automatic recording of blood pressure at set intervals over 24 hours (day and night) using a cuff worn on the upper arm. It is used to evaluate white-coat effect, masked hypertension, and nocturnal blood pressure.

Indication

• Evaluating high in-clinic readings that appear normal at home (white-coat hypertension)
• Investigating masked hypertension in patients with normal in-clinic readings but signs of organ involvement
• Assessing response to current therapy and daytime blood pressure variability in known hypertension
• Resistant hypertension that cannot be controlled despite multiple medications
• Dizziness, lightheadedness, or transient syncope after antihypertensive medication
• Evaluation of high blood pressure during pregnancy and suspected preeclampsia
• Measuring nighttime blood pressure in conditions where blood pressure variability matters, such as sleep apnea, kidney disease, and diabetes

Preparation

• Continue your regular medications unless told otherwise; the device measures your blood pressure under your current treatment
• Wearing a single-layer, loose-fitting thin shirt under the cuff makes things easier
• The device is not waterproof; you cannot shower or bathe during recording, so finish hygiene tasks beforehand
• On the recording day, you are asked to maintain your usual daily activities (work, walking, sleep); do not deliberately slow down
• You are expected to keep a diary of your sleep times, medication times, and any symptoms

How it's performed

1. An appropriately sized automatic blood pressure cuff is placed on your arm and connected to a recording device carried in a pouch
2. The device automatically measures every 15-30 minutes during the day and every 30-60 minutes at night
3. When the device alerts you to a measurement, you should stop and keep your arm still and at heart level
4. Not talking, not tensing the arm, and sitting if possible improves accuracy
5. You keep a diary of your activities (walking, work, meals, smoking, medication times) and your bedtime/wake-up times
6. When the recording period ends, the device is returned and the physician evaluates the readings as daytime, nighttime, and overall averages

Post-procedure

• The physician's report evaluates daytime average, nighttime average, and the percentage of nocturnal blood pressure dipping separately
• Based on findings, medication may be started, doses adjusted up or down, or dosing times (morning/evening) changed
• If nighttime blood pressure does not drop adequately ("non-dipper" pattern), additional investigation and lifestyle recommendations are made
• Based on results, home blood pressure monitoring, salt restriction, weight loss, and exercise plans are organized
• Persistent dizziness, vision disturbances, or fainting during measurement requires prompt medical attention

Risks

• Ambulatory blood pressure monitoring is painless and risk-free; no medication is given
• When the cuff inflates, you may feel temporary pressure, mild numbness, or marks on the arm
• Frequent measurements may cause sleep interruption, especially on the first night
• In sensitive skin, redness or rarely a small bruise may occur under the cuff
• A slipped or loosened cuff can cause inaccurate readings; in this case, the recording day may need to be repeated

FAQ

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