2. Introduction to Ambulatory Blood Pressure Monitoring
Ambulatory blood pressure monitoring (ABPM) is an accepted clinical tool for collecting multiple blood pres
-
sure measurements. ABPM data is intended to better assist clinicians with the diagnosis and management
of hypertension by providing data related to: blood pressure variability, estimation of true blood pressure,
overnight changes in blood pressure, blood pressure load, sleep blood pressure dipping, and morning surge
in blood pressure
. In-clinic and home blood pressure measurements cannot provide the same depth of in
-
formation that a 24-hour study provides. Several studies have shown that ambulatory blood pressure moni
-
toring, when compared to clinic or home blood pressure measurement, is superior in predicting target organ
damage, morbid events, or cardiovascular risk.
The data obtained from ambulatory blood pressure monitors is accurate and useful for managing a wide
variety of hypertensive situations including:
•
White-coat hypertension
•
Resistant hypertension
•
Masked hypertension
•
Childhood hypertension
•
Efficacy of anti-hypertensive drug therapy on a 24-hour basis
•
Nocturnal hypertension
•
Episodic hypertension and/or anxiety disorders
•
Hypotensive symptoms
•
Changes in diet and daily routine designed to reduce hypertension
3. Introduction to Central Blood Pressure Monitoring
Central blood pressure measurement derives the central aortic pressure waveform from cuff pulsations
recorded non-invasively at the brachial artery. Analysis of the waveform provides key parameters including
central systolic pressure, central pulse pressure and indices of arterial stiffness such as augmentation pres
-
sure and augmentation index. Increased central systolic pressure and augmentation index have been shown
to be markers of cardiovascular risk. Additionally, research has shown its significance as a biomarker for
guiding assessment of drug safety and efficacy and, ultimately, patient treatment.
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