ABPM

Ambulatory blood pressure monitoring (ABPM) is a diagnostic method in which a portable device worn on the body records blood pressure at regular intervals over 24 hours or longer while the patient goes about daily activities and sleep. A cuff around the upper arm inflates automatically to measure systolic and diastolic blood pressure and often heart rate, with readings typically every 15 to 30 minutes during the day and every 30 to 60 minutes at night.

ABPM provides a comprehensive profile of blood pressure, including 24-hour, daytime, and nighttime averages, as well as the extent of nocturnal dipping. It can identify abnormal patterns such as white coat hypertension (elevated office readings with normal ambulatory measurements), masked hypertension (normal office readings with elevated ambulatory measurements), and nocturnal hypertension. The data are used to calculate BP load and to assess circadian rhythm, which can influence cardiovascular risk assessment and treatment decisions. ABPM is commonly employed to evaluate treatment efficacy, assess adherence, and help diagnose resistant hypertension.

Compared with office-based measurements and home monitoring, ABPM offers several advantages: it reduces observer bias, captures blood pressure during normal daily activities and sleep, and provides prognostic information that correlates with organ damage and cardiovascular outcomes. Limitations include patient discomfort, potential sleep disturbance, incomplete data due to movement or cuff issues, and reduced accuracy in certain conditions such as arrhythmias or extreme body size. ABPM is recommended in various hypertension guidelines for specific clinical scenarios and is a valuable tool in individualized blood pressure management.