 |
Ambulatory Blood Pressure Monitoring Ambulatory Blood Pressure Monitoring (ABPM) is used to exclude white-coat hypertension.
WHAT IS WHITE-COAT HYPERTENSION?
This is a condition in which blood pressure is persistently elevated in the presence of a doctor, but falls to normal values when the patient leaves the medical environment. The condition can only be detected by ABPM or by self-monitoring. There are no known predisposing factors such as personality type, reactivity to stress, biochemical or physiological variables. Initially thought to be benign, there is increasing evidence that the prognosis for patients with ‘white-coat’ hypertension is intermediate between that of those who have nomotension and those with established hypertension.
- Can only be detected by ABPM or self-monitoring.
- May not be benign; definitive outcome studies are needed.
- Requires continued surveillance, involving self-monitoring and repeat ABPM at 1-2 year intervals.
- Does not respond to standard drug therapy.
WHY USE AMBULATORY BLOOD PRESSURE MONITORING?
- To exclude white-coat-hypertension.
- End-organ damage is more closely correlated with ambulatory blood pressure than with clinic blood pressure readings.
- ABPM provides a 24-hour profile, allowing assessment of clinic effects, drug effects, work influence, etc.
HOW TO INTERPRET AMBULATORY BLOOD PRESSURE (ABP) PROFILE
- ABPM profiles should be inspected in relation to diary information and time of drug treatment.
- Normal ABPM values for adults (non-pregnant) are:
< 135/85 mmHg during the day.
< 120/75 mmHg during the night.
< 1430/80 mmHg over 24 hours.
- Daytime and night-time ABPM loads should be < 20% above normal values.
Mean day-time and night-time (sleep) ABPM measurements should differ by > 10%
|
