USE OF AMBULATORY BLOOD PRESSURE MONITOR (ABPM) FOR GUIDING CARDIAC PATIENTS MANAGEMENT
Yzhar Charuzi, M.D., UCLA School of Medicine, CA, USA
24-hours ambulatory blood pressure monitoring has been for years a useful tool to assess variability in blood pressure beyond office checks or self-measurement. We decided to investigate the impact of ABPMs on patient management. The common indication for applying the test was uncertainty of BP fluctuations over a course of 24 hours. Our retrospective study included 250 studies on 164 patients over the span of over 15 years. The study population was 60% male and 40% female and ranged from 18 to 89 years of age. In patients who had more than one test, the shortest span was 7 months. Tests were classified as normal (exhibiting satisfactory distribution of BP with minimal deviation), as abnormal high (over 50% of readings over 140), as abnormal low (with any readings below 80), or partially abnormal (mixed with under 50% of abnormal readings either high or low). The results showed that 49% of tests were satisfactory, 30% were abnormally high, 3% were abnormally low, and 18% were partially abnormal. The clinical assessment depended upon test results. In 50% of the tests, the patient was reassured and advised to continue current treatment; in 13%, a change in medication timing was advised; in 9%, an increase in medication dosage was indicated; in 3%, a decrease in medication was recommended; in 21%, a new medication was added, and in 4%, a behavioral change was advised. In conclusion, 24-hours ABPM is a valuable tool in assessing uncertainties of BP control based on office measurements.