How to Make Good ABPM Blood Pressure Monitor Recordings
The ABPM blood pressure monitor is an effective tool for 24-hour blood pressure control, because it gives information over and above conventional blood pressure meters. However, making good recordings is not easy. In order to do so, some steps should be taken into consideration.
Rules of Making Ideal ABPM Blood Pressure Monitor Recordings
1. Inform the patient about the aim of the ABPM monitoring. The ABPM blood pressure monitor is able to make repeated measurements up to or even over a 24 hour period of time, even at night-time, which supports the identification of non-dippers and away from medical environment, which helps to filter patients with white coat hypertension.
If the patient tends to have white-coat hypertension, which means that his blood pressure is high only in medical setting, there is a possibility to set ABPM blood pressure monitoring to 27 hours. In this way the patient will have enough time to return into normal state after leaving the medical environment.
2. Ask the patient about his daily routine: when he starts and finishes the day. The information is necessary to decide on active (day) and passive (night) ABPM blood pressure monitoring periods.
3. The ABPM blood pressure monitor should be put into a protective carrying case (or pouch), which is fixed to the patient's belt. The carrying case may have straps as well, which should be adjusted to the patient.
4. Selecting the right cuff size is essential for accurate readings. Therefore you need to measure around your upper left arm somewhere around the midpoint between your shoulder and elbow.
Meditech supplies small, normal and large cuffs to its ABPM blood pressure monitors. Small cuff should be used if your arm circumference range is 32 cm maximum; normal cuff should be applied if your range is between 29 – 38 cm and large adult should be used if your range is between 35 – 46 cm.
Wearing a thin shirt under the cuff is recommended, as it can prevent problems caused by long-time wear of the cuff (sweat, itching, soreness).
The cuff should be placed on to the patient's left arm. In general: the ABPM blood pressure montior cuff should cover two-thirds of the distance from the patient's elbow to your shoulder.
The cuff should be properly connected to the ABPM blood pressure monitor. The cuff connector is on the upper side of the device, if it is placed into the carrying case.
5. The patient should avoid excess movement during ABPM blood pressure monitoring, so the arm should be held loose, slightly away from the chest.
6. Should the batteries run down during a monitoring session, they can be dimply replaced. Monitoring will continue and data will not be lost.
Read more on the use of Meditech ABPM-05 blood pressure monitor!
Ambulatory Blood Pressure Monitoring & Renal Denervation
Early trials found that renal denervation had resulted in significant drops in systolic blood pressure. Renal denervation, a new, catheter-based blood pressure lowering technology, which aims at the interruption of the nerve connection to the organ or its part, might be a 'cure' for resistant hypertension and, as a result, it may also be a tool for eliminating antihypertensive drug therapy. Early trials found significant drops, in the range of 30 mmHg, however, latest analyses are about a much more modest blood pressure reduction of about 11 mmHg – according to a scientific article has recently been publised in Forbes.
According to the latest studies the blood pressure lowering effect of renal denervation has been over-estimated because recorded data were based on office blood pressure measurements instead of the far more reliable and consistent measurements of an ambulatory blood pressure monitor.
Why ambulatory blood pressure monitor measurements are more reliable?
On one hand, the ambulatory blood pressure monitor carries out more measurements and real blood pressure is reflected more accurately by repeated measurements.
In addition, the ambulatory blood pressure monitor provides a blood pressure profile away from clinical environment, thereby it allows the identification of patients with white coat hypertension. White coat hypertension is identified in patients, whose blood pressure is elevated when it is measured by an office blood pressure meter, but it is normal when an ambulatory blood pressure monitor is applied, just because their blood pressure is recorded away from clinical environment. Consequently, office blood pressure meters are misleading in people with white coat hypertension and inapropriate treatment may be applied if medical decisions are based on them.
Finally, ambulatory blood pressure measurements are more reliable because blood pressure is recorded at night-time as well.
Office blood pressure meters in the renal denervation study
Office blood pressure meters proved to be less reliable in the recent study for a number of reasons as well.
For one, medical professionals are likely to repeat blood pressure readings they think are inconsistent with their clinical impression of the patient.
Another factor is that patients are more likely to participate in such trials when they have elevated blood pressure in the office.
People with white coat hypertension cannot be filtered out with office blood pressure meters, in this case an ambulatory blood pressure monitor should be applied.
Finally, patients with resistant hypertension may not take antihypertensive drugs as prescribed. Therefore, the treatment effect in these patients may be much more significant.
ABPM Blood Pressure Monitor & ECG 2in1 Package Promotion
Autumn Promotion: ABPM Blood Pressure Monitor & ECG Event Recorder 2in1 Package
Order Meditech BlueBP-05 ABPM blood pressure monitor with CardioBlue ECG event recorder in 1 package and receive 30% discount!
The Bluetooth-capable BlueBP-05 ABPM blood pressure monitor and CardioBlue looping ECG event recorder make extended ambulatory blood pressure and looping ECG event monitoring possible and now the 2 devices are available in 1 package for the price of one.
ABPM blood pressure monitors are being increasingly used in clinical practice worldwide, as ambulatory (Holter) monitoring gives information over and above conventional blood pressure measurements. Don't miss out this opportunity! For your ABPM blood pressure monitor you will receive a 3-channel Bluetooth-capable looping ECG event recorder as well!
2in1 Package Advantages
- 2 products in 1 system with full software options
The software is free and contains full software options with visual graphs, detailed statistics, event distribution, manual editing option, both default and freely customizable, printable reports.
In case of BlueBP-05 ABPM blood pressure monitor the Holter software contains basic ABPM data, such as average day and night time values and it provides a visual plot as well. Should you need more information on the patient's condition for your study, you can also find detailed statistics on the 24 hour profile, pulse pressure, blood pressure load, diurnal index, hypertensive time index, hypotensive time index and morning surge.
In case of CardioBlue looping ECG Event recorder, the software contains the event annotation and the event distribution with the possibility of manual alterations. The software saves time for you, as it groups ECG beats automatically, in this way noisy or abnormal beats can be identified very quickly.
- Bluetooth technology for eliminating the use of fibre optic connecting cables
- up to 3-year warranty
- suitability both for busy general practices and for research purposes
- accuracy is proved by independent validations
BlueBP-05 ABPM blood pressure monitor: 1 x ABPM recorder unit, 1 x carrying case, 1 x normal size, latex cuff, 2 x sets of batteries, 1 x Bluetooth dongle, 1 x CD with the latest software (CardioVisions Personal Edition) and user documentation, 1 x quality certificate packed in carton box.
CardioBlue ECG event recorder: 1 x ECG recorder unit, 1 x AAA alkaline battery, 7 x lead patient ECG cable, 1 x package of disposable ECG electrodes, 1 x quality certificate packed in carton box.
Promotion Deadline: 30. November 2013
Until Stocks Last
Ambulatory Blood Pressure Monitoring in the UK
NICE Hypertension Guidelines – Key Priorities
High blood pressure is one of the leading causes of premature morbidity and mortality in the UK, therefore hypertension management is also one of the most common interventions in primary care. National Institute for Health and Care Excellence (NICE) provides guidance and advice to improve health. The new hypertension guidelines include updated recommendations on blood pressure measurement and contain information on the use of ambulatory blood pressure monitoring, blood pressure targets and antihypertensive drug treatment. The guidelines should carefully be considered by healthcare professionals, but the guidance does not replace the professonals' knowledge and skills.
Stage 1 hypertension: clinic blood pressure is 140/90 mmHg or higher and ambulatory blood pressure monitoring (ABPM) daytime average or home blood pressure monitoring (HBPM) average blood pressure is 135/85 mmHg or higher.
Stage 2 hypertension: clinic blood pressure is 160/100 mmHg or higher and subsequent ABPM daytime average or HBPM average blood pressure is 150/95 mmHG or higher.
Severe hypertension: clinic systolic blood pressure is 180 mmHG or higher or clinic diastolic blood pressure is 110 mmHg or higher.
Ambulatory blood pressure monitoring – offered automatically above 140/90 mmHg
NICE guidelines contain clear instructions on how to diagnose hypertension. Key priorities include:
1. If clinic blood pressure is equal or above 140/90 mmHg, ambulatory blood pressure monitoring (ABPM) is automatically offered to confirm the diagnosis of hypertension.
2. When ambulatory blood pressure monitoring is used, minimum 2 measurements are necessary to be taken hourly during the patient's usual waking hours. Waking hours are called 'active period' in ambulatory blood pressure monitoring (for example between 08:00 and 22:00). The average value of at least 14 measurements should be used to confirm a diagnosis of hypertension.
3. When using traditional home blood pressure monitoring (HBPM) to confirm a diagnosis of hypertension, ensure that:
- for each blood pressure recording 2 consecutive blood pressure measurements are taken at least with 1 minute difference and with the person seated and
- blood pressure is recorded twice daily in the morning and evening and
- blood pressure recording lasts for at least 4 days, but 7 days are preferable.
Discard measurements taken on the first day and use the average value of all the remaining measurements to confirm a diagnosis of hypertension.
Antihypertensive drug treatment
Antihypertensive drug treatment should be initiated and offered:
1. For people aged under 80 years with stage 1 hypertension who have :
- target organ damage and/or
- established cardiovascular damage and/or
- renal disease and/or
- diabetes and/or
- a 10-year cardiovascular risk equivalent to 20% or higher.
2. For people of any age with stage 2 hypertension
3. For people aged under 40 years with stage 1 hypertension and no evidence of target organ damage, cardiovascular damage, renal disease, diabetes, get a specialist evaluation of secondary causes of hypertension and a more detailed assesement of potential target organ damage.
Monitoring treatment and blood pressure targets
For people with white coat effect, which is a discrepancy of more than 20/10 mmHg between clinic and average daytime ABPM or average HBPM blood pressure measurements at the time of diagnosis, consider ABPM or HBPM as 'confirmation' to clinic blood pressure measurements to monitor the effects of antihypertensive treatment.
Source: NICE clinical guidelines 127 - developed by the Newcastle Guideline Development and research Unit and ipdated by the National Clinical Guideline Centre and the British Hypertension Society
Top 10 High Blood Pressure Risk Factors
High blood pressure or hypertension is dangerous because it forces the heart to work harder and it contributes to hardening of the arteries. Most hypertensive people do not even know about their condition, in spite of the fact that hypertension is the leading cause of cardiovascular disease worldwide and it is associated with more than 13 percent of all deaths globally.
Majority of Hypertensive Patients are not Aware of Their Condition
A new study published in the Journal of the American Medical Association is about a research in which 142,042 patients from 17 countries were involved. More than 53 percent of the participants did not even know about their high blood pressure. Among the patients who were aware of their hypertensive condition, more than 87 percent were receving any kind of drug treatment. However, only about 33 percent of them had their high blood pressure under control. Uncontrolled hypertension is rather typical for low income countries but still significant is high and middle income countries too.
The exact causes of blood pressure are not known, but there are several risk factors to consider. By taking attention to the risk factors below you can minimise the risk of high blood pressure and heart disease.
1. Older Age
Being older than 55 is a significant risk factor for having elevated blood pressure.
Women are less likely to develope high blood pressure than men.
Ethnic background plays an important factor in the development of high blood pressure. African-Americans tend to have higher risk for hypertension. On contrary, Asian population have the lowest demonstrated risk of high blood pressure.
The family history of high blood pressure may increase the risk.
Smoking is the number 1 risk factor which should be controlled.
6. Unhealthy Diet
The more you weight the more risk you undertake to develop high blood pressure.
Lack of sport leads to weak heart and obesity.
Certain medications may cause or worsen hypertension.
9. Kidney Problems
Kidneys play an important role in regulation of blood pressure, therefore any damage in them may cause high blood pressure
10. Other Medical problems
Secondary hypertension can be caused hormone imbalances, anatomic abnormalities or tumors.