AMBULATORY BLOOD PRESSURE MONITORING (24-HOUR SPHYGMOMANOMETER)
Ambulatory blood pressure monitoring (ABPM) involves the use of a noninvasive device that measures blood pressure in 24-hour cycles (24 hour sphygmomanometer). The device consists of a portable sphygmomanometer attached to a recording device. The ABPM device is fitted to and removed from the individual by a trained technician. The sphygmomanometer inflates at predetermined times, generally every 30 minutes, and the blood pressure recorded at each inflation is stored. The individual performs normal activities while wearing the monitor. The device provides information about blood pressure during daily activities, as well as during sleep.
Ambulatory blood pressure monitoring is considered more accurate than individual self-monitoring. Therefore, it is generally thought that readings obtained at frequent intervals throughout the day and night would help the professional provider better manage the individual's care. These stored, 24-hour measurements are later interpreted at the professional provider’s office. A clinician is required to interpret the collected data by uploading it onto a computer where device specific programs are used to categorize and analyze the measurements.
The information that ABPM provides, for example, can help a professional provider determine whether an individual is truly hypertensive or is exhibiting white coat hypertension (WCH). WCH is a condition characterized by persistently raised blood pressure in the doctor's office with a normal ambulatory blood pressure. WCH is defined as blood pressure greater than 130/80 mmHg on at least three clinic/office visits, with two separate measurements made at each visit, and blood pressure less than 130/80 mmHg documented on at least two separate blood pressure measurements taken outside the office.
HOME BLOOD PRESSURE MONITORING DEVICES
Blood pressure management using HBPM, is an important component for risk management in individuals with end-stage renal disease (ESRD). Hypertension is highly prevalent among individuals who have ESRD requiring dialysis or a kidney transplant.
The two main types of home blood pressure monitoring (HBPM) devices are non-automatic and automatic (or electronic). Many of these devices are available for retail purchase, and some have undergone technical validation according to recommended protocols.