Ambulatory BP monitoring

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• Measures BP every 20-30 mins traditionally over 24 hours.

• Safe, and not usually associated with complications,

• They are quiet, lightweight and easy to wear,

• Occasionally some bruising or petechiae develop

 

Indications

• Suspected white coat hypertension

• Suspected masked hypertension

• Suspected night time hypertension ( the night non dipper)

• Htn despite appropriate treatment

• people with a high risk for cardiovascular events

• Also good for;

  • Titrating antihypertensives

  • Borderline hypertension

  • Hypertension detected early in pregnancy

  • Suspected or confirmed Obstructive Sleep Apnoea

  • Syncope or other features suggesting orthostatic hypertension

 

Contraindication

• Although not a contraindication, likely to be inaccurate with AF and other arrhythmias

• Where does it fit;

  • More accurate than clinic BP’s- which commonly overestimate

  • Come in after bathing- you can’t get it wet.

  • Wear a top with loose sleeves

  • Do normal daily activities

  • Preferably a work day rather than a rest day

  • When the cuff starts going the person should stop moving and stop talking and keep the arm still and relaxed

  • Keep a brief diary to record timing of activities, sleep, taking of meds, any symptoms.

 

Results

• 24 hr average<115/75, hypertension threshold 130/80

• day time < 120/80 threshold 135/85

• night <105/65 threshold 120/75.

• Night timer average should be >10% less

• BP Load = ( % of times above threshold should be < 20%.

• If % successful readings > 85% then its an OK test

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AFP 2011