Ambulatory blood pressure monitoring (ABPM) is a non-invasive diagnostic test that continuously records blood pressure over 24 hours as patients go about their daily activities. This technique provides crucial information about blood pressure patterns, circadian variations and the adequacy of pharmacological blood pressure control. At Livasa Hospital, ABPM is utilised for diagnosis of suspected hypertension, assessment of treatment efficacy and investigation of resistant hypertension.

Understanding Ambulatory Blood Pressure Monitoring

ABPM involves wearing a portable blood pressure monitor connected to a small cuff that automatically inflates at programmed intervals (typically every 15–30 minutes during waking hours and every 30–60 minutes during sleep). The device records blood pressure readings continuously, documenting systolic and diastolic pressures throughout the day and night.

This comprehensive data provides information that cannot be obtained from office blood pressure measurements alone, including:

• Average daytime and nighttime blood pressures

• Blood pressure variability throughout the day

• Circadian blood pressure patterns

• Response to daily activities and stress

• Adequacy of medication effect

• Presence of white-coat or masked hypertension

Clinical Indications for ABPM

ABPM is recommended for:

• Suspected white-coat hypertension – Elevated office blood pressure with normal out-of-office readings

• Suspected masked hypertension – Normal office blood pressure but elevated out-of-office readings

• Assessment of antihypertensive therapy – Determining if treatment adequately controls blood pressure throughout the day

• Resistant hypertension – Inadequate response to three or more antihypertensive medications

• Nocturnal hypertension – Suspected elevated nighttime blood pressure

• Hypotension episodes – Unexplained dizziness or syncope

• Autonomic dysfunction – Orthostatic hypotension or blood pressure instability

The ABPM Procedure

The ABPM test at Livasa Hospital involves simple steps:

1. Patient arrives at the hospital or outpatient clinic for device setup

2. A blood pressure cuff is fitted on the non-dominant arm

3. The portable monitor is attached to a belt worn around the waist

4. The device is programmed with desired recording intervals

5. Patient returns home or continues daily activities

6. Device records blood pressure automatically throughout 24 hours

7. Patient returns the device the next day

No activity restrictions are required, and most patients tolerate the procedure well. Some patients report minor discomfort from cuff inflation, but serious complications are rare.

Blood Pressure Pattern Classification

ABPM results are classified based on nighttime blood pressure patterns:

• Dippers – Normal 10-20% reduction in nighttime versus daytime blood pressure

• Non-dippers – <10% reduction in nighttime blood pressure

• Reverse dippers – Nighttime blood pressure exceeds daytime pressure

• Extreme dippers – >20% reduction in nighttime pressure

Abnormal dipping patterns are associated with increased cardiovascular risk.

Analysis and Reporting

Comprehensive ABPM reports include:

• 24-hour average systolic and diastolic blood pressure

• Daytime average blood pressure

• Nighttime average blood pressure

• Blood pressure load (percentage of readings above target)

• Blood pressure variability indices

• Morning blood pressure surge

• Heart rate variability

• Graphical and tabular data presentations

Clinical Utility and Decision-Making

ABPM results guide clinical decisions:

• Diagnosis confirmation – Distinguishing white-coat from sustained hypertension

• Treatment initiation – Determining need for pharmacotherapy

• Dose adjustment – Optimising antihypertensive medication regimens

• Treatment intensification – Recognising inadequate control

• Discontinuation consideration – Documenting control in patients on treatment

Advantages of ABPM

• More representative of actual blood pressure over 24 hours

• Better predictor of cardiovascular risk than office blood pressure

• Reduces unnecessary treatment in white-coat hypertension

• Identifies patients needing more intensive therapy

• Assesses circadian patterns and nighttime hypertension

• Evaluates medication timing and duration of action

Why Choose Livasa Hospital?

• Experienced hypertension specialists interpreting ABPM data

• Integration with comprehensive hypertension management programs

• Access to advanced pharmacotherapy options

• Long-term follow-up and treatment optimisation

NAP – Contact Details

Livasa Hospital Mohali
Sector 71, Sahibzada Ajit Singh Nagar (SAS Nagar)
Mohali, Punjab – 160071
Phone: +91-80788 80788 (24/7 Emergency)
Website: www.livasahospitals.com

Call +91-80788 80788 to schedule ambulatory blood pressure monitoring at Livasa Hospital.