Holter blood pressure: what is the ABPM (Ambulatory Blood Pressure Monitoring) for?

By Cristiano Antonino On Sep 2, 2022

The ABPM or blood pressure monitor is a diagnostic tool that allows the dynamic recording of blood pressure for 24 hours

One of the most useful tools available to the doctor for assessing the blood pressure profile even in children is the ABPM (Ambulatory Blood Pressure Monitoring)

This is a 24-hour blood pressure measurement system.

It consists of a small recorder connected via a flexible tube to a blood pressure cuff.

The recorder is set so that the cuff inflates at regular intervals.

The interval between measurements can be changed according to clinical-diagnostic needs, but usually the device records the pressure every 15 minutes during daylight hours and every 30 minutes during sleep to allow physiological rest.

With these settings, it is possible to obtain approximately 70-75 blood pressure measurements in 24 hours.

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Over the last few years, there has been a gradual increase in the diagnosis of hypertension (non-occasional increase in blood pressure values) in the paediatric population not only due to an increased prevalence of risk factors such as overweight, sedentary lifestyle and consumption of foods high in salt, but also due to continued advances in diagnostic methodologies.

The benefits of this are clearly evident:

It makes it possible to rule out ‘white-coat hypertension’: a temporary rise in blood pressure values caused by emotional stimuli as may occur during a medical examination;
Allows monitoring of blood pressure during the night;
Allows the difference between daytime and night-time blood pressure values to be determined, which is useful information in certain diseases;
Heart rate (number of heartbeats per minute) can be recorded during measurements.

In addition to its diagnostic usefulness, the ABPM allows the effectiveness of any antihypertensive therapies to be assessed

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Certain conditions must be met in order to obtain reliable results:

The examination must be carried out in specialised centres and the equipment must be set up and applied by appropriately trained personnel;
The appropriate cuff must be selected: one of the most frequent errors in blood pressure measurement, especially in paediatric settings, is the use of cuffs that are not the right size for the length and circumference of the arm;
The cuff should be placed on the non-dominant arm (i.e. the one that is used less often), except in cases of illness;
The first measurement should always be compared with the pressure taken at rest during the examination to check for any discrepancies that may be indications of equipment malfunction;
The patient and family member should be carefully instructed in the operation of the equipment (measurement intervals, any audible alarms);
The parent (or the patient in the case of older children) should fill in a diary of the day, noting the main activities carried out, hours of sleep and any symptoms.
Children, even very young ones, usually tolerate this type of examination well if they are well educated and reassured.

Last, but not least, is the speed with which the results are read and interpreted by qualified personnel.