Blood Pressure Monitoring for Ambulatory Patients
Ambulatory blood pressure monitoring (ABPM) is a non-invasive method for tracking and evaluating daily fluctuations in your blood pressure while you go about your normal activities. Because this test exists, it has become the most common test used to diagnose and monitor hypertension in patients.
During an ABPM test, you wear a small blood pressure cuff connected by tubing to a band around your upper arm. This lightweight band contains an inflatable bladder, which inflates at set intervals during the day through the tube attached to the automated sphygmomanometer. This allows your doctor to look at the pressure in your arteries when you are resting, active, and sleeping. The information is then sent wirelessly to a computer that generates reports.
Why should I use the ABPM?
ABPM is a more convenient option than having your blood pressure measured in the doctor’s office or clinic several times each year. As durable medical equipment, it provides 24-hour ambulatory blood pressure monitoring, giving you closer to average results because of its accuracy and ability to monitor your habits during sleep. It’s better than having patient appointments all the time or always being brought to the emergency department for treatment.
What Are the Benefits of Ambulatory Blood Pressure Monitoring for Ambulatory Patients?
ABPM can help diagnose high blood pressure in people who may not realize they have it. It is the standard-of-care method for identifying “white coat hypertension.” This is a condition where people have high blood pressure during medical exams but normal blood pressure at other times.
ABPM can also provide critical information to your doctor, who may face difficult decisions about what medication dose to prescribe, whether you’re at risk of heart attack or stroke, or whether you should have a referral order for surgery. An ambulatory referral can also help your doctor evaluate how effective a new medication lowers blood pressure and improves the patient experience with their health care provider.
In general, the benefits of ABPM include:
• Reduced effects of white coat hypertension
• Lower rate of benign prostatic hyperplasia (BPH) diagnosis in men over 50 years old who have symptoms of BPH with a routine prostate exam
In addition, ABPM is used in clinical trials or a pilot study to evaluate the effects of new drugs and treatment regimens for hypertension.
Several types of ambulatory monitoring tests monitor your BP over a more extended period, such as an entire 24-hour period or a week. These tests provide a complete picture of your BP fluctuations and may be used to diagnose sleep apnea or autonomic disorders such as Parkinson’s disease.
What Are the Risks of Ambulatory Blood Pressure Monitoring?
There are very few risks associated with ABPM, such as:
• Skin irritation around the cuff where it is applied
• Irritation of the inside of your arm from the tube
Some people are at risk for more severe complications, such as:
• Bruising or bleeding under the skin while you wear the cuff
• Allergic reaction to tape used to attach the tubing around your arm
Don’t hesitate to ask your doctor if you have any questions about the risks of this procedure.
How Do I Prepare for An Ambulatory Bp Monitoring Test?
It’s important to tell your doctor about any medications you take, including supplements or herbal remedies, because some may alter how ABPM works. Your doctor may ask you to stop taking these medications before the test to not interfere with the results.
Your doctor may also ask you to change your eating and drinking habits before the test to get better results, such as:
• Drinking less water
• Eating a salt-restricted diet the day before the test
• Avoiding alcohol and caffeine for 24 hours before the test
Your doctor may also recommend that you avoid smoking for several hours before the test.
How Will I Feel when I Have the Abpm?
Many people are nervous when they have their first test, but most find it tolerable, and some experience relief after learning why their blood pressure is high. You’ll be able to relax during the test because you’ll be at rest and able to lie down. If you’re feeling anxious, ask the technician performing the test if you can sit up instead of lying down.
Once everything is set up, you won’t have to do anything except relax for about an hour while the device takes your BP reading. Afterward, your doctor will give you your results and talk about what they mean.
How does ABPM work?
Your doctor may order an ABPM test if they suspect that your BP isn’t controlled with medication or that you are taking the wrong dosage. ABPM provides a complete picture of your blood pressure at different times of day, which can help determine whether your readings are regular for you and what factors may be affecting them during the day. For example, if your blood pressure is higher at night, you may be retaining fluid throughout the day.
Also, follow these simple steps:
1. Attach the device to your arm
2. Relax and lie down for an hour while it takes measurements
3. Your doctor will analyze results and discuss them with you during a follow-up appointment
How Is Abpm Different from Home Blood Pressure Monitoring?
Home or office BP readings are taken using an inflatable cuff attached to a standard stethoscope. A patient typically takes their BP readings four times in a row, with at least five minutes between each reading. This provides one average lesson. Accurate home BP monitoring can help you manage your medication and understand what affects your blood pressure throughout the day. Still, it does not give a complete picture of a patient’s complete daily readings.
How long is an ABPM test?
ABPM takes approximately eight hours, and some insurance plans may cover all or part of the cost. The test is usually scheduled when you aren’t taking your blood pressure medication so that the results aren’t affected by it.
Who performs an ABPM?
Your doctor or nurse can schedule and perform an ABPM test for you. You may also order an ABPM test yourself and take the device to a local drug store for reading. However, it is essential to remember that you need an accurate blood pressure reading, which requires training in using the machine and interpreting the results.
Your doctor or nurse will attach a cuff around your arm and inflate it with air. The cuff will expand to the size of your arm and be connected by tubing to an inflatable bladder in a small box nearby. A stethoscope is attached to the package to record blood pressure readings as they occur. The machine itself will resemble a rugged plastic cell phone with a screen, and it may attach to your belt or be worn around your neck.
The bladder within the box responds to pressure changes in your arm and inflates and deflates, allowing air from inside the cuff to escape. Blood flow creates sounds transmitted through the tubing attached to the stethoscope and recorded by the machine. This will enable you to take your blood pressure without assistance.
When does an ABPM test begin and end?
The test begins in the morning when you first wake up and ends at your regular bedtime. You may need to wear the machine all day or for just part of the day if your doctor only wants to monitor your blood pressure overnight. The reading will be taken at the same time every day.
Is an ABPM test safe?
The cuff used during an ABPM measures blood pressure in your arm, not your heart, so it is safe for most people. However, if you cannot feel the heartbeat on your wrist or upper arm, it may be difficult to detect which blood vessels are being compressed. If this is the case, your doctor may ask you to monitor your blood pressure at home before scheduling an ABPM test.
Is an ABPM test accurate?
One of the benefits of an ABPM test is that it provides a complete picture of how your blood pressure changes each day and night. A standard reading can determine if you have high blood pressure. But an ABPM helps determine why your blood pressure is too high, making it easier to adjust treatment and lifestyle changes.
What happens after an ABPM is taken?
Your doctor will review the results and discuss a course of action to lower your blood pressure. It may take several weeks or months to get an ABPM test result after being scheduled for one. If you get high home readings, ask your doctor about setting up an ABPM appointment.
What should I do if my average blood pressure readings at home and work are high?
Remember to use your home BP monitor before coming in for your appointment. This will help your doctor interpret the results of the ABPM test. If you already have a diagnosis of hypertension, an ABPM test can show what time of day it is most severe and how tightly your medication controls your BP.
If you do not know what time of day your blood pressure is elevated, and ABPM test could be beneficial in diagnosing the problem. An ABPM test may also show whether certain activities affect your BP. For example, it can help determine if stress at work causes high readings or bedtime hypertension is related to sleep apnea.
How often should I have an ABPM test?
The frequency of ABPM tests will vary depending on your reason for getting one and your results. Your doctor may order several readings during a single appointment or schedule you for more frequent testing if your medication regimen is being adjusted, if lifestyle changes are not reducing the level of your high blood pressure, or if you are showing signs of other conditions that may be related to elevated blood pressure.
How much does an ABPM test cost?
The price of an ABPM test varies depending on where you live and the specific equipment used by your doctor. Many insurance companies cover this test to diagnose and monitor high blood pressure. Check with your insurance provider about the cost of an ABPM test before you schedule one.
Can I get an ABPM test on my own?
No, an ABPM test must be ordered by a physician. However, your doctor may give you a prescription to purchase an ABPM monitor. You can then take the test in the comfort of your own home.
ABPM is not recommended for children under age 18 or pregnant women.
What are the expected results?
In general, blood pressure should be lower at night than during the day. The average adult has the highest blood pressure in the morning and the lowest during the night.
What are abnormal results?
If your ABPM test shows that your blood pressure is high, you may need further tests to determine if this problem is caused by other factors, such as stress or kidney disease. Your doctor will work with you to review the results, discuss treatment options, and determine if you need further testing.
Can I take my highblood medicine while using ABPM?
It is important to always follow your doctor’s advice about taking any blood pressure medication. If you are scheduled for an ABPM test, do not stop or start any medications before the appointment. Your doctor will discuss with you if your medicine needs to be adjusted after reviewing your results.
Will my insurance cover ambulatory care?
Insurance coverage of ABPM varies from company to company. In general, most health plans will require a physician’s order before the test can be done for outpatient services. Please make sure you confirm with your insurer that they participate with the service provider’s network of physicians.
ABPM can help diagnose high blood pressure and hypertension and help monitor treatment progress. If you think you may have high blood pressure or are looking for a more accurate way to track your blood pressure progress, ask your doctor about getting an ABPM test. They also refer patients for ambulatory surgery or other medical procedures depending on their findings.