Ambulatory Blood Pressure Monitoring: Five Decades of More Light and Less Shadows

Abstract

Casual blood pressure measurements have been extensively questioned over the last five decades. A significant percentage of patients have different blood pressure readings when examined in the office or outside it. For this reason, a change in the paradigm of the best manner to assess blood pressure has been observed. The method that has been most widely used is the Ambulatory Blood Pressure Monitoring - ABPM. The method allows recording blood pressure measures in 24 hours and evaluating various parameters such as mean BP, pressure loads, areas under the curve, variations between daytime and nighttime, pulse pressure variability etc. Blood pressure measurements obtained by ABPM are better correlated, for example, with the risks of hypertension. The main indications for ABPM are: suspected white coat hypertension and masked hypertension, evaluation of the efficacy of the antihypertensive therapy in 24 hours, and evaluation of symptoms. There is increasing evidence that the use of ABPM has contributed to the assessment of blood pressure behaviors, establishment of diagnoses, prognosis and the efficacy of antihypertensive therapy. There is no doubt that the study of 24-hour blood pressure behavior and its variations by ABPM has brought more light and less darkness to the field, which justifies the title of this review.

Impaired circadian rhythm of blood pressure predicting adverse events in preeclampsia

“…Evidences suggested that those with non-dipper and reverse dipper profile had higher risk of mortality and of cerebrovascular events. 7 We had similar results using timed (6 hourly) blood pressure monitoring, those with non-dipper (M/N ratio 1 to 1.09) and reverse dipper profile (M/N ratio <1) had 90 and 60 percent of complications (maternal or fetal) respectively. Those cases with dipper profile (M/N >1.10) were reported to have no maternal or fetal complications.…”

“…6 As expected, reversed BP rhythm is found to be associated with the more severe form of preeclampsia. 7 These studies are mainly done using ABPM (ambulatory blood pressure monitoring). However there had been issues regarding tolerance of same by patients.…”

The Effects of Low Dose Sertraline on Blood Pressure in Patients with Hypertension and Panic Disorder: A Pilot Study

“…BP was measured every 30 minutes during the day and hourly at night. ABPM reflects not only the diurnal variation in BP, but also reflects real-life situations that vary throughout the day [24] [25]. After the 24 hour recording was completed, the BP monitor was returned and data downloaded to automated software and stored on a secure server.…”

What is the best way to measure blood pressure?

“…With the advent of ABPM, it was possible to identify phenotypes previously unknown, such as: white coat hypertension and masked hypertension [8].…”