Ambulatory blood pressure monitoring (ABPM) measures blood pressure

Blood pressure

Blood pressure is the pressure exerted by circulating blood upon the walls of blood vessels, and is one of the principal vital signs. When used without further specification, "blood pressure" usually refers to the arterial pressure of the systemic circulation. During each heartbeat, BP varies...

 at regular intervals . It is believed to be able to reduce the white coat hypertension

White coat hypertension

White coat hypertension, more commonly known as white coat syndrome, is a phenomenon in which patients exhibit elevated blood pressure in a clinical setting but not in other settings...

 effect in which a patient's blood pressure is elevated during the examination process due to nervousness and anxiety caused by being in a clinical setting. Out-of-office measurements are highly recommended as an adjunct to office measurements by almost all hypertension organizations.

Nocturnal hypertension

Ambulatory blood pressure monitoring allows blood pressure to be intermittently monitored during sleep, and is useful to determine whether the patient is a dipper or non-dipper--that is to say whether or not blood pressure falls at night compared to daytime values. A night time fall is normal. It correlates with relationship depth but other factors such as sleep
quality, age, hypertensive status, marital status, and social network support. Absence of a night time dip is associated with poorer health outcomes, including increased mortality in one recent study. In addition, nocturnal hypertension is associated with end organ damage and is a much better indicator than the daytime blood pressure reading.

Target organ damage

It has been shown that end-organ damages related to hypertension, such as left ventricular hypertrophy, narrowing of the retinal arteries are more strongly associated with ABPM than with a clinical BP measurement, the reason being clinical BP measurement are referred to the marked variability of BP measurement and white coat effect .

Morning surge

The day-night time fluctuates with values rising in the daytime and falling after midnight. With these changes, its possible to calculate the BP dip, with categories such as non-dipper (<10%), dipper, extreme dipper, and reverse dipper. Independent studies have shown that for subject with blunted or abolished fall dip and abnormal ABP result in higher incidences of LV hypertrophy and CV mortality .
According to the American Heart Association

American Heart Association

The American Heart Association is a non-profit organization in the United States that fosters appropriate cardiac care in an effort to reduce disability and deaths caused by cardiovascular disease and stroke. It is headquartered in Dallas, Texas...

, an excessive morning blood pressure surge is a predictor of stroke in elderly people with high blood pressure .

This is based on the American Heart Association's calculation, using systolic blood pressure (SBP):

Range	Class
<0%	Reverse Dipper
0% - 10%	Non-Dipper
10% - 20%	Dipper
>20%	Extreme Dipper

Blood pressure variability

24-hour, non-invasive ambulatory blood pressure monitoring allows estimates of BP variability.

International Research

ARTEMIS http://www.artemisnet.org](international Ambulatory blood pressure Registry: TEleMonitoring of hypertension and cardiovascular rISk project) is the first International Ambulatory Blood Pressure Monitoring Registry aiming at assessing the actual degree of blood pressure and cardiovascular risk control of hypertensive patients followed by doctors all over Europe. The project is based on telemonitoring on BP through a web-based telemedicine service (MOREPRESS at www.morepress.net).

External links

• ARTEMIS, international Ambulatory blood pressure Registry: TEleMonitoring of hypertension and cardiovascular rISk project
• Ambulatory blood pressure monitoring, Medical Journal of Australia