Ambulatory Blood Pressure Monitoring
What is ABPM?
Ambulatory blood pressure monitoring provides the doctor with important diagnostic and therapeutic information; in some cases it can also provide a more reliable evaluation of the effectiveness of medication than tests carried out during consultations.
The ABPM procedure
ABPM involves the use of a small recording device which is worn around the waist and connected to an armband. This test provides an objective evaluation of blood pressure during the various activities of daily life.
In general the ABPM recorder takes blood pressure readings every 15 minutes during the day and every 20 minutes at night time.
A certain numbers of rules should be followed for ABPM to ensure the quality of the readings:
- the test should be carried out on an active person, outside of week-ends or any sick or holiday leave;
- a detailed diary of your daily activities should be kept such that the doctor can relate any blood pressure variations with daily activities where applicable.
Fitting the device
The ABPM devices are fitted at the Functional Testing Unit by a member of its nursing staff (nurse or care-assistant); after the 24 hours of ambulatory monitoring, the results will be interpreted by Dr Dominique de Zuttere.
The nurse who fits the device will explain that, at any time, you may:
- trigger a blood pressure reading by simply pressing a button;
- or suspend the readings if you are experiencing any problems caused by the inflation of the armband.
Once the device has been fitted you can leave the hospital and go about your normal activities, avoiding damaging the device or getting it wet of course. You will be asked to return to the hospital to return the device 24 hours later, at the end of the test. The contents of its solid state memory will then be transferred to a computer terminal for processing and interpretation by the cardiologist using special software. The results will be included in the final report as figures (individual readings, averages for daytime, night-time and the whole 24 hour period, etc.) and as a graphic representation.
What indications will ABPM provide?
- During medical consultation you may present “unreliable” or slightly increased blood pressure readings, your doctor may want to be able to differentiate between a “real” high blood pressure condition and one that is just a reaction to danger (the doctor’s white-coat effect);;
- Alternatively, you may already be receiving treatment for high blood pressure and your doctor may wish to evaluate the effectiveness of the treatment over an extended period of time (24 hours) covering periods of daytime activity and night time rest;
- Or you may have symptoms of malaise and/or dizziness, 24 hours of blood pressure readings will provide information about the possibility of a low blood pressure condition.
ABPM is not useful when High Blood Pressure has been clearly detected during a medical consultation.
What are the benefits of ABPM?
The blood pressure reading which would indicate a case of High Blood Pressure is 135/85 millimetres of mercury (13.5/8.5) during the day and 125/75 millimetres of mercury (12.5/7.5) during the night. An average of 130/80 mmHg for a 24 hour period is considered the reference. ABPM provides a means to confirm or discard a High Blood Pressure diagnostic through the application of these thresholds.
It is also very important to be aware of the variations between day and night blood pressure readings. Night-time blood pressure should normally be 10% lower than the active daytime average. Some patients do not display this cycle and this is one of the indications of the severity of a High Blood Pressure condition, which may also indicate the presence of an endocrine disorder.
A number of studies have shown the usefulness of this test to predict the cardiovascular incidents: blood pressure measured over a 24 hour period seems to be a very good way of evaluating cardiovascular risks (notably myocarditis or strokes).
How long will you have to wait for the results?
Generally speaking it takes 24 hours to compile the results of the test, after which you will be able to pick them up from the service’s reception. If the results of the test require, the cardiologist who interprets the readings may call your doctor directly with a summary of the results. In certain cases (patients resident outside of the Paris region or unable to travel) the results may be sent to your home address or to your doctor by post.
Practical information
Dr Dominique de ZUTTERE, Cardiologist, Paris Hospital Physician, member of the French Cardiology Association.
Monday to Thursday
Appointments: 01 47 59 55 01 or 01 47 59 59 50