Ambulatory blood pressure
You don't need to be Editor-In-Chief to add or edit content to WikiDoc. You can begin to add to or edit text on this WikiDoc page by clicking on the edit button at the top of this page. Next enter or edit the information that you would like to appear here. Once you are done editing, scroll down and click the Save page button at the bottom of the page.
| Ambulatory blood pressure Classification and external resources |
| Cardiology Network |
 Discuss Ambulatory blood pressure further in the WikiDoc Cardiology Network |
| Adult Congenital |
|---|
| Biomarkers |
| Cardiac Rehabilitation |
| Congestive Heart Failure |
| CT Angiography |
| Echocardiography |
| Electrophysiology |
| Cardiology General |
| Genetics |
| Health Economics |
| Hypertension |
| Interventional Cardiology |
| MRI |
| Nuclear Cardiology |
| Peripheral Arterial Disease |
| Prevention |
| Public Policy |
| Pulmonary Embolism |
| Stable Angina |
| Valvular Heart Disease |
| Vascular Medicine |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Phone:617-632-7753
Please Take Over This Page and Apply to be Editor-In-Chief for this topic: There can be one or more than one Editor-In-Chief. You may also apply to be an Associate Editor-In-Chief of one of the subtopics below. Please mail us [2] to indicate your interest in serving either as an Editor-In-Chief of the entire topic or as an Associate Editor-In-Chief for a subtopic. Please be sure to attach your CV and or biographical sketch.
Ambulatory blood pressure monitoring (ABPM) measures blood pressure at regular intervals throughout the day and night. It is believed to be able to reduce the white coat hypertension effect.
Studies are listed below supporting the thesis that ABPM is a far better method than clinical measurements.
Nocturnal hypertension
Ambulatory blood pressure monitoring allows blood pressure to be continually monitored during sleep, and is useful to determine whether the patient is a dipper or non-dipper, that is to say whether or not blood pressure falls at night compared to daytime values. A night time fall is normal. Absence of a night time dip is associated with poorer health outcomes. In addition, nocturnal hypertension is associated with end organ damage[1] and is a much better indicator than the daytime blood pressure reading.
Target organ damage
- See also: End organ damage
It has been shown that end-organ damages related to hypertension, such as left ventricular hypertrophy, narrowing of the retinal arteries are more strongly associated with ABPM than with a clinical BP measurement, the reason being clinical BP measurement are referred to the marked variability of BP measurement and white coat effect [2].
Morning surge
The day-night time fluctuates with values rising in the daytime and falling after midnight. With these changes, its possible to calculate the BP dip, with categories such as non-dipper (<10%), dipper, extreme dipper, and reverse dipper. Independent studies have shown that for subject with blunted or abolished fall dip and abnormal ABP result in higher incidences of LV hypertrophy and CV mortality [3].
According to the American Heart Association, an excessive morning blood pressure surge is a predictor of stroke in elderly people with high blood pressure [4] [5].
This is based on the American Heart Association's calculation, using systolic blood pressure (SBP):
| Range | Class |
|---|---|
| <0% | Reverse Dipper |
| 0% - 10% | Non-Dipper |
| 10% - 20% | Dipper |
| >20% | Extreme Dipper |
Blood pressure variability
24-hour, non-invasive ambulatory blood pressure monitoring allows estimates of BP variability.
References
- ↑ Use and interpretation of ambulatory blood pressure monitoring: recommendations of the British Hypertension Society
- ↑ Clinical Usefulnesses of Ambulatory Blood Pressure Monitoring, Paolo Verdecchia, Fabio Angeli, Roberto Gattobigio
- ↑ Monday Morning Surge in Blood Pressure May Lead to Increase in Cardiovascular Events, American Heart Association
- ↑ Morning surge in blood pressure linked to strokes in elderly
- ↑ Stroke Prognosis and Abnormal Nocturnal Blood Pressure Falls in Older Hypertensives
External links
Acknowledgement and Attribution Regarding Sources of Content
Some of the initial content on this page may be incorporated in part from copyleft sources in the public domain including wikis such as Wikipedia and AskDrWiki. Drug information for patients came from the The National Library of Medicine. Infectious disease information may have come from the Centers for Disease Control (CDC). Differential Diagnoses are drawn from clinicians as well as an amalgamation of 3 sources: 1.The Disease Database; 2. Kahan, Scott, Smith, Ellen G. In A Page: Signs and Symptoms. Malden, Massachusetts: Blackwell Publishing, 2004:3; 3. Sailer, Christian, Wasner, Susanne. Differential Diagnosis Pocket. Hermosa Beach, CA: Borm Bruckmeir Publishing LLC, 2002:7 .
