Ambulatory Blood Pressure Monitoring
Ambulatory Blood Pressure Monitoring
Ambulatory blood pressure monitoring has become a widely used method of blood pressure and heart rate evaluation in the free-living subject. Recently, ambulatory monitoring has become covered by Medicare for the evaluation of "white-coat" hypertension. Although the technique provides only intermittent readings throughout the 24-hour period, average blood pressures obtained in this way correlate well with a variety of hypertensive disease processes and are also a better prognostic marker for future cardiovascular events than office blood pressure. Ambulatory blood pressure averages also correlate well with indices of diastolic dysfunction. In patients with congestive cardiac failure and systolic dysfunction, ambulatory monitoring suggests an impaired circadian blood pressure profile with high nocturnal blood pressure. Further research is needed on the relationship between ambulatory blood pressure and cardiac dysfunction, as well as the impact of observed circadian blood pressure changes on outcome. (CHF. 2001;7:319-324) ©2001 CHF, Inc.Noninvasive, intermittent blood pressure monitoring, otherwise known as ambulatory blood pressure monitoring (ABPM), was first developed more than 30 years ago. There have been major technologic advancements since this early, somewhat cumbersome model, which required patient activation of each measurement. More than 25 automated, noninvasive devices are commercially available for use in children and adults, and such devices are now more compact, fully automated, and electronically sophisticated. Furthermore, the methodology has evolved from its initial role as a research tool to become an integral part of drug development, and it is increasingly used in clinical practice for the diagnosis and management of hypertension.
In this review, we briefly discuss current device methodology and the use of ABPM in clinical hypertension, provide an overview of the relationship between ABPM and left ventricular hypertrophy (LVH), and review the limited contribution of ABPM in the assessment of congestive heart failure (CHF).
Ambulatory blood pressure monitoring has become a widely used method of blood pressure and heart rate evaluation in the free-living subject. Recently, ambulatory monitoring has become covered by Medicare for the evaluation of "white-coat" hypertension. Although the technique provides only intermittent readings throughout the 24-hour period, average blood pressures obtained in this way correlate well with a variety of hypertensive disease processes and are also a better prognostic marker for future cardiovascular events than office blood pressure. Ambulatory blood pressure averages also correlate well with indices of diastolic dysfunction. In patients with congestive cardiac failure and systolic dysfunction, ambulatory monitoring suggests an impaired circadian blood pressure profile with high nocturnal blood pressure. Further research is needed on the relationship between ambulatory blood pressure and cardiac dysfunction, as well as the impact of observed circadian blood pressure changes on outcome. (CHF. 2001;7:319-324) ©2001 CHF, Inc.Noninvasive, intermittent blood pressure monitoring, otherwise known as ambulatory blood pressure monitoring (ABPM), was first developed more than 30 years ago. There have been major technologic advancements since this early, somewhat cumbersome model, which required patient activation of each measurement. More than 25 automated, noninvasive devices are commercially available for use in children and adults, and such devices are now more compact, fully automated, and electronically sophisticated. Furthermore, the methodology has evolved from its initial role as a research tool to become an integral part of drug development, and it is increasingly used in clinical practice for the diagnosis and management of hypertension.
In this review, we briefly discuss current device methodology and the use of ABPM in clinical hypertension, provide an overview of the relationship between ABPM and left ventricular hypertrophy (LVH), and review the limited contribution of ABPM in the assessment of congestive heart failure (CHF).
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