Ambulatory Blood Pressure Monitoring

Patients using ambulatory blood pressure monitoring can feel free to carry out their normal daily activities while they wear this device.

Did you know that uncontrolled high blood pressure contributes to the development of many heart diseases, like heart failure, heart attack, stroke, and others? As the number of deaths due to raised blood pressure continues to rise to 7.5 million worldwide, various innovative technologies to constantly monitor blood pressure are also emerging.

Ambulatory blood pressure monitoring (ABPM) is the gold standard method to monitor and record the patient's blood pressure and heart rate throughout the 24-hour period at fixed intervals. It is done to confirm the diagnosis of hypertension or rule out other possible causes of high blood pressure, like white coat hypertension, nocturnal hypertension, or others. 

Dr. Ankur Phatarpekar, one of the top, experienced and highly qualified interventional cardiologists in Mumbai, discusses ambulatory blood pressure monitoring in detail, including how it's done, who is the right candidate for it, why it's essential and more.

1. Dr. Ankur Phatarpekar, how does ambulatory blood pressure monitoring work? 

Dr. Ankur Phatarpeker: You will wear the ambulatory blood pressure monitor, a small portable device, on a belt or strap around your body and attach its BP cuff to your arm for 24 hours. 

The device will automatically record your blood pressure at fixed intervals for over a 24-hour period even when you are asleep. 

It normally records your blood pressure every 30 minutes during the day and every 60 minutes at night, and you can continue your daily activities while wearing the device. 

Your doctor will then take an average reading of your blood pressure after the 24-hour period.

2. Who needs to use an ambulatory blood pressure monitor? 

Dr. Ankur Phatarpeker: Ambulatory blood pressure monitoring is typically recommended for patients who experience high blood pressure but haven't been diagnosed with any specific disease, like hypertension or need closer blood pressure monitoring. They are also recommended for patients requiring adjustments to their current blood pressure medications or treatment.

They are also prescribed to the following patients: 

• Patients whose blood pressure is high in the healthcare setup but normal when they are at home. Ambulatory blood pressure monitoring can help diagnose this condition known as white coat hypertension. 
• Who have high blood pressure despite medication use. 
• Who experiences fainting episodes.

3. Dr. Ankur Phatarpeker, what guidelines would you recommend to patients about ambulatory blood pressure monitors? 

Dr. Ankur Phatarpeker: Patients using ambulatory blood pressure monitoring can feel free to carry out their normal daily activities while they wear this device. They only need to avoid strenuous activities, showering or swimming during the 24 hours of wearing ABPM. Moreover, patients should avoid removing the monitor before asking their healthcare provider. 

It is ideal to choose a 24-hour ambulatory blood pressure monitoring period that best represents the patient's normal daily routine. 

Patients should also note down their activities during the blood pressure monitoring period, including: 

• The time and names of medications they took.
• The food they ate.
• Any physical exertions they did.
• Any symptoms they experienced, like chest pain, dizziness, headache, or others.

4. What are the disadvantages of ambulatory blood pressure monitoring (ABPM)? 

Dr. Ankur Phatarpeker: One disadvantage of ABMP is that patients may feel irritation or soreness in their arm when the device inflates to check their blood pressure every 30-60 minutes. The inflation may also cause disruption while sleeping.

5. What is the alternative to ABPM? 

Dr Ankur Phatarpeker: A more comfortable and cost-effective alternative to ambulatory blood pressure monitoring (ABPM) is home blood pressure monitoring (HBPM). It measures your blood pressure during the day and night when you are seated and at rest over a more extended period (for several days) rather than a 24-hour period. 

However, ambulatory blood pressure monitoring (ABPM) is a more accurate method to diagnose hypertension. HBPM measures your blood pressure only when you are at home, while ABPM measures and records your blood pressure outside and inside your home.

Conclusion
Blood pressure monitoring is crucial in patients with frequently raised blood pressure as unaddressed high blood pressure can cause many health issues, including heart disease, kidney damage, vision loss, coronary artery disease, and other chronic conditions. 

Ambulatory blood pressure monitoring (ABPM) can help patients record their blood pressure and heart rate automatically with ongoing daily activities. It helps confirm the diagnosis of their disease and identify or switch the treatment plan accordingly. 

Choosing the right cardiologist can provide patients step-by-step guidance on addressing their disease. Dr. Ankur Phatarpeker, an experienced interventional cardiologist in Mumbai, develops tailored treatment plans prioritizing their patients’ well-being and heart health.

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