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Ambulatory Blood Pressure Monitoring

What is an Ambulatory Blood Pressure Monitor?

Ambulatory Blood Pressure (ABP) monitoring is a diagnostic tool designed to monitor the blood pressure over 24 hours and thus gain an overall profile of variation in a day. It is a portable test undertaken in the course of a normal day. The test is entirely painless however some pressure on the arm may be felt when the blood pressure cuff is inflating. It can be used for infants, children or adults. 

How does the Ambulatory Blood Pressure Monitor work?

The Monitor measures and records blood pressure readings from the brachial artery at pre-programmed time intervals. The monitor is equipped with an internal pump to inflate the cuff and all recordings are stored on a solid state memory card. The ABP Monitor can measure and record blood pressure readings every 30 minutes between 7am and 10pm and then every hour between 10pm and 7am.

Reasons for the procedure

The main aim of ABP monitoring is to document blood pressure over a given period (usually 24 hours). Blood pressure readings may then be correlated with daily activities and symptoms. Some reasons for your physician to request an ABP monitor may include:

• To distinguish random elevation of blood pressure (eg. white coat hypertension).
• To predict cardiovascular events, mortality or end organ disease.
• To monitor blood pressure in renal disease, which can help prevent cardiovascular morbidity and further aggravation of renal disease that can result from poorly controlled blood pressure.
• To monitor the effects of drugs on your blood pressure.

Putting the ABP Monitor on

1. Your physician/technician will explain the procedure to you and offer you the opportunity to ask any questions that you might have about the reading.
2. Your height and weight will be recorded. This information will be used when interpreting your blood pressure results.
3. An appropriately sized cuff will be securely attached to your arm. The cuff tubing will then be connected to the ABP Monitor, which may be clipped onto a belt and worn around your waist.
4. To verify proper ABP Monitor operation, two or more blood pressure readings will be taken to check repeatability.
5. You will be instructed to keep a detailed diary of activity, posture, sleep and medication times to allow interpretation of the relationship between blood pressure and activity.
6. Once you have been hooked up to the monitor and given instructions, you can return to your usual activities, unless your physician instructs you differently. This will allow your physician to identify problems that may only occur with certain activities.

Taking the ABP Monitor off

Simply remove the cuff from your arm. You must return the entire device, along with the diary to the Cardiac Department on level three, between 8:30am and 5:00pm, Monday to Friday. After hours it can be returned to Edgar Stephens Ward on level three, or it may be returned in a prepaid courier bag which can be purchased from reception.

Are there any risks involved?

ABP monitoring is a safe and acceptable method of taking blood pressure measurements. It can be successfully performed on nearly all children. Prolonged application of the cuff may cause bruising or swelling at the application site, although this is uncommon. There may be other risks depending upon your specific medical condition. Be sure to discuss any concerns with your physician prior to wearing the monitor.

Ambulatory Blood Pressure Monitor analysis and interpretation

All blood pressure data is transferred to a computer for analysis. Symptoms recorded in the diary can then be correlated with changes in the blood pressure over the 24 hour period.

Troubleshooting tips

If the monitor is not detecting blood pressure (if the cuff does not inflate):

1. Ensure you are still and your arm is straightened whilst the monitor is taking a blood pressure reading. Sometimes arm movement can limit the machine's capacity to detect blood pressure.
2. Ensure the cuff is positioned correctly on your upper arm with the arrow pointing downwards towards your inner elbow.
3. Check the tubing which connects the cuff to the ABP monitor is not kinked.
4. Ensure the tubing connection to the ABP monitor is secure.

To manually record a blood pressure, press the blue button located on the top of the monitor box. Your technician will show you how to do this.

Frequently Asked Questions

How do I pay for the ABP monitoring test?
For Medicare card holders the Hospital will bulk bill (please remember to bring your Medicare card).

How long will the test take?
The ABP Monitor records for 24 hours. A blood pressure measurement is taken and recorded every 30 minutes between 7am and 10pm, and then every hour between
10pm and 7am.

Can I have a shower or swim during the test?
No. Water will cause damage to the monitor.

Do I have to do anything during the ABP monitoring?
Yes. You will need to keep a diary of your activities during the recording period. Your physician/technician will give the diary to you.

When will I receive the ABP Monitor results?
Results of the test and a report will be forwarded to your referring doctor. If you have further questions, please speak to your referring doctor or telephone (02) 9845 2345.

Precautions

Please take care of the monitor.

• Do not drop the monitor
• Do not get the monitor wet

The cost of any damage caused to the monitor will have to be reimbursed in full.

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