What Does a 24 Hour Blood Pressure Monitor Detect

High BP accounts for more than 9 million deaths per year, surpassing tobacco usage with around 8 million deaths per year.

High BP is harmful when it is left uncontrolled for long time.  A short-term fluctuation in BP rarely harms. Such fluctuations occur during stress, coffee intake, immediately before passing urine and stools  and during anxious times. Also, normally BP should fall around 10 -15 mmHg during sleep. Checking BP frequently and getting anxious over mild fluctuations  is not advisable. BP recordings may be taken according to your doctors’ advice as individual patients may require different methods of approach to assess and control BP.

WHAT IS 24 HRS BP MONITORING?

Recording a person’s BP over 24 hours (both during awake time and sleep) continuously along side their routine activities is called 24 hrs BP monitoring.

With 24 hrs BP monitoring it is possible to identify whether there is a normal fall in BP or extreme fall in BP or if there is paradoxical rise in BP during sleep. This information is very important to adjust the dose of  medications to optimise the BP levels.  In People with no fall in BP or rise in BP at night, there will be a higher risk for heart attack, brain stroke or even death particularly in hypertensives.

Patients with diabetes, snoring and kidney failure will have more chances of paradoxically high BP at night.

Early morning rise in BP is very common in many people especially during winter season particularly in smokers. This is also one of the reasons for increased incidence of heart attacks during early morning hours.

HOW DOES THE 24 HRS BP MACHINE WORKS?

It is a small device which is attached to the NON DOMINANT ARM (left arm in right-handed individuals) of the patient. Every 30 mins the device will inflate automatically and record the BP. It is preset to measure at least 21 readings during the day and 7 readings at night. The cuff should not be removed during the 24 hrs test period. The inflations might cause little bit discomfort but nothing to worry.

After 24 hours, the patient returns, and the data is downloaded and analysed. The essential information  includes  the 24-hour average blood pressure, the average daytime blood pressure, the average night-time blood pressure, and the calculated percentage drop in blood pressure at night.

INSTRUCTIONS TO BE FOLLOWED DURING THE TIME OF 24 HRS AMPB:

1. Avoid heavy exercise
2. Avoid taking bath
3. Do not remove the cuff at all.
4. Continue with daily routine activities
5. Whenever the cuff is ready to measure , patient should sit comfortably during that time without talking or walking.
6. Any significant activity may be recorded in a notebook like drinking coffee, watching live game shows or movies, office hour starting , going to bed time etc for better understanding of the BP changes.

WHY 24 HRS BP IS IMPORTANT?

It helps us identify different groups of high BP patients. It is very useful to plan the right BP medication, monitor response to treatment, assess the reason for failure to respond adequately to medications and also for dose adjustment.

WHO WILL BENEFIT FROM 24 HRS BP MONITORING?

1.WHITE COAT HYPERTENSION

In this condition, the patient will have high BP recordings whenever he visits the hospital or clinic but he will have normal BP at home both during day and night

2.MASKED HYPERTENSION

In this condition patient will have normal BP in clinic but his BP will be high both during night and day time at home.

3.NOCTURNAL HYPERTENSION;
in this condition, patient will not have normal fall in BP during sleep. Instead, they will have high BP during sleep. These people are at higher risk for heart attack, brain stroke and kidney failure

4.EARLY MORNING HYPERTENSION:

Most heart attacks and brain strokes happen during early morning hours due to hormonal changes at that time. Some people with high BP, have a surge during morning hours which may go unnoticed with routine single time BP measurements

5.RESISTANT HYPERTENSION:

Some people will have high BP in spite of being on 3 medications for BP control. Before adding another tablet to the existing treatment, it is always important to confirm resistant hypertension and then increase the tablets to avoid excessive fall in BP and its side effects

6.DURING PREGNANCY:

During pregnancy BP control may be a challenge. Careful monitoring and strict control of BP is very important to avoid complications related to high BP. For this 24 hrs BP recording will be useful.

A good control of BP is very important for a better quality of life and for a healthy heart and kidney functioning. For a better understanding of the patients’ blood pressure pattern, initiating the right amount of medications to control the BP, monitor the response to treatment and before making any dose adjustments it is very important to get a 24hrs BP monitoring for better decision making.