Ambulatory Blood Pressure Monitoring
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Blood pressure varies significantly over a 24 hour period
and single, elevated measurements do not necessarily reflect the true
position. Ambulatory monitoring during routine daily activities provides
several readings throughout the day and night and offers a profile of
blood pressure during rest as well as activities. It is especially
important in differentiating spuriously high readings (white coat effect)
from true sustained hypertension.
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The cuff is permanently on the arm and the recorder placed on a belt or rucksack. There are several ambulatory monitors available for use in paediatric patients. Most use the oscillometric technique and correlate the reading with simultaneous recording of the heart rate which is also plotted on the graph. These monitors print the actual readings and mean BP values during time periods throughout the 24 hours. The normal values in the
paediatric
population are still uncertain. Nevertheless mean systolic values of
130 mm Hg for the 24 hour period with peak values of 160 mm Hg during
physical activity have been suggested as acceptable ( Treatment decisions should be based on the mean
values over the monitored period and take into account the shape
of the profile.
Normal 24 hour profiles show a fall in the blood pressure level
during sleep - evidence suggests that patients with no fall
(non-dippers) have an increased risk of end organ damage.
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This page was last edited 16/2/2004 |
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