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Advice from the BP Measurement Experts

Why Should I Use ABPM?

Friends walking in a park

 

Diagnosing and treating hypertension is serious business, and as research shows, ABPM is far superior to other testing available to clinicians. ABPM provides valuable diagnostic information that in-clinic and home blood pressure monitoring systems are incapable of measuring including:

  • BP variability and a more accurate estimation of true blood pressure
  • Overnight changes in blood pressure (dipper status)
  • Morning surges in blood pressure

 

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Letting the Dust Settle on New Hypertension Guidelines

Female Nurse Drawing Heartline

The April 2015 edition of Cardiology Today includes an interesting article – “New Hypertension Recommendations Anticipated in 2016” - stating that the American Heart Association (AHA) and the American College of Cardiology (ACC), in collaboration with nine other medical societies, will be releasing new hypertension guidelines that will serve as an update to those released by the Seventh Joint National Committee (JNC 7) in 2003.

But, wait…weren’t updated guidelines already published back in 2013? As a matter of fact, they were!

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The Role of ABPM in Diagnosing Hypertension

Mature Man being consulted by a Physician

The US Preventive Services Task Force (USPSTF) Weighs In

According to the Centers for Disease Control and Prevention, 67 million American adults (31%) have high blood pressure – that’s 1 out of every 3 adults. Depending upon the severity of the condition, typically diagnosed by in-office BP measurements, blood pressure medication and/or lifestyle modifications may be prescribed.

Although in-office BP measurements are typically used to diagnose hypertension, several studies have shown that other diagnostic options are far more reliable - specifically, the use of a 24-hour, ambulatory blood pressure monitoring device (ABPM).

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Do I REALLY Need Treatment for Hypertension?

Picture of a various pills forming the shape of a question mark.

Were You Properly Diagnosed?

A vast amount of physicians are diagnosing hypertension without properly assessing a patient’s blood pressure during the course of a 24-hour period using Ambulatory Blood Pressure Monitoring. Simply put, ABPM provides valuable diagnostic information that in-clinic and home blood pressure monitoring systems are incapable of measuring including:

  • BP variability and a more accurate estimation of true blood pressure
  • Overnight changes in blood pressure (dipper status)
  • Morning surges in blood pressure
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ABPM Makes a Lot of Cents

ABPM ReimbursementAmbulatory Blood Pressure Monitoring (ABPM) is a commonly-used tool for the identification and treatment of hypertension with a variety of clinical applications including identification of white-coat hypertension, diagnosis of masked hypertension, monitoring the efficacy of anti-hypertensive treatment, and identification of resistant hypertension. One common question from both those preparing to implement ABPM in their practice, and current ABPM users alike, is whether or not it is a reimbursable procedure.

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World’s Leading ABPM Experts Publish Position Paper

ESH logoJust two months ago the European Society of Hypertension (ESH) released its new guidelines for the management and treatment of arterial hypertension at its annual meeting. ESH remains active in publishing guidance documents and has now released its latest position paper. The topic is Ambulatory Blood Pressure Monitoring (ABPM).

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Get Out of the Office for Better BP Measurement

Out of Office BPThough we state it often, we at SunTech Medical aren't the only ones touting the utility of monitoring BP outside of a clinical setting. A recent article published by a northeastern regional news website advocates for the use of home BP (HBPM) and ambulatory BP monitoring (ABPM) to diagnose and monitor hypertension. An estimated 50% of patients experience either white coat hypertension or masked hypertension. Therefore, as Dr. David Landers is quoted in the article, "'One blood pressure reading in the office is not useful. What you need is more data points.'"

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ABPM Could Be Exactly What The Patient Needs

ABPM Can Catch Overnight DippingThe above title is how author Craig Bowron, MD capped off his recent article “Traditional blood-pressure cuffs not that reliable.” As I was reading the article, I was pleased to see how successful the 15-physician clinic in Minneapolis had been with implementing an Ambulatory Blood Pressure Monitoring (ABPM) program to identify, diagnose and manage their hypertensive patients. One physician was quoted as saying “It’s been breathtaking to see how much difference there can be between office blood pressure readings and what we’ve found with ambulatory [ABP] monitoring”. The practice was able to  lower or end treatment on 13% of their patients after ABPM testing revealed that they were being over-treated. Conversely, 18% had their medication added or increased as their ABPM results showed they were under-treated.

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Love Lowers BP and Healthcare Costs

Love Lowers BPAh, love. Valentines Day brings it front and center – roses, candy, and sentiments to loved ones. Aside from the moments of terror and corresponding spike in blood pressure that can be brought on by the realization that you have forgotten to plan for this celebration, the emotion of love can be of invaluable help in reducing stress and blood pressure.

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Don't Break a Hip: How ABPM Can Help

As we have all heard time and time again hypertension is a prevalent public health issue, but it affects the elderly at a much higher rate. A newly published study now warns that "caution" is needed when initiating new antihypertensive drugs to treat elderly patients. The findings, published last month in the Archives of Internal Medicine (AIM), showed that elderly patients had a 43% increased risk of having a hip fracture within the first 45 days following the start of new antihypertensive treatment.1 It is reportedly "'the first study to demonstrate an immediate increased risk of hip fracture on initiation of antihypertensive drug therapy in community-dwelling hypertensive elderly patients'". The researchers also hypothesized that the most likely cause of the hip fractures were falls related to orthostatic hypotension, which can have symptoms such as dizziness and fainting.2

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American Society of Hypertension Urges CDC to Use ABPM

Oscar 2 ABPM Device

Last week, we blogged on the recent report from the Centers for Disease Control and Prevention (CDC) that noted some pretty serious concerns about our national state of health as it relates to hypertension and its potentially deadly effects.

This week, we want to draw your attention to a press release from the American Society of Hypertension urging the CDC to incorporate ambulatory blood pressure monitoring (ABPM) as a way to apply a more "sensitive and specific tool for assessing blood pressure in its national surveys."1

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Interval Exercise: A New Approach to Lowering BP

Breaking Up Your Exercise May lower BP more EffectivelyExercise has long been recommended to patients wanting a non-pharmaceutical approach to achieving lower blood pressure (BP). The American Heart Association (AHA) specifically recommends:

  • At least 150 minutes of moderate intensity aerobic physical activity (2 hours and 30 minutes) each week.
  • Incorporate your weekly physical activity with 30 minutes a day, at least 5 days a week.
  • Physical activity should be performed in episodes of at least 10 minutes, and preferably, should be spread throughout the week.
  • Include flexibility and stretching exercises.
  • Include muscle strengthening activity at least 2 days each week.1
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Speculation over implementation of NICE Guidelines on ABPM begins

nice-guidelines-abpmThree months ago, the National Institute for Health and Clinical Excellence (NICE) in the UK released new guidelines for managing hypertension in adults. The new recommendations call for the use of Ambulatory Blood Pressure Monitoring (ABPM) to confirm a diagnosis of hypertension when a patient has a clinic BP reading of 140/90 mmHg or above. One of the major questions raised was how this would be implemented.

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Hypertension Diagnosis: Be confident and save money with an ABPM Study

Be confident with an ABPM studyHypertension is a prevalent condition globally and is quickly becoming a focus in the U.K., with particular emphasis on how to best diagnose the condition. In August, a study comparing blood pressure (BP) measurement methods, which was funded by the U.K.’s National Institute for Health and Clinical Excellence (NICE), was published on the same day that NICE announced the release of its new guidelines for hypertension management in adults.

In the study, Cost-effectiveness of options for the diagnosis of high blood pressure in primary care: a modelling study, the research found that “ambulatory monitoring is cost effective compared with further monitoring in the clinic or home for confirming the diagnosis of hypertension” for all age and gender groups considered. Specifically, ABPM provided cost savings ranging from £56 in men aged 75 years to £323 in women aged 40 years (Equivalent to $89 and $511 respectively). Additionally, it was determined that ambulatory blood pressure monitoring (ABPM) “resulted in improved health outcomes for male and female age groups older than 50.”

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Should Ambulatory Blood Pressure Monitoring Be Required?

Dr. Henry Black discusses ABPMDr. Henry Black, former President of the American Society of Hypertension, presents this very question in his recent video on Medscape News. While Medscape requires a free login account to view their content, we felt this report rather significant and worthy of sharing.

In the video article, Dr. Black points out that the practices of how we measure blood pressure are changing as technology advances and becomes more available. He also explains that while home monitoring is becoming more commonplace, studies of ambulatory blood pressure monitoring (ABPM) are telling us more about its unique prognostic benefits. 

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In-Office Ambulatory Blood Pressure Monitoring: Could it replace traditional office BP assessment?

traditional doctors officeThat’s just the question Dr. Mark C. van der Wel and colleagues sought the answer to in an article published in the Annals of Family Medicine. As we at SunTech have mentioned in previous posts, two of the most prevalent problems with traditional in-office blood pressure assessment is improper observer technique and the white-coat effect.  As a way to overcome this, the authors developed a method of taking a series of in-office automated oscillometric blood pressure readings for 30 minutes by utilizing an ambulatory blood pressure monitor (ABPM) and compared those results with mean daytime ABPM results.

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SunTech's Blood Pressure Technology Logs Over 2 Decades of Space Exploration

SunTech Accutracker II on NASA flightTraditionally, we try not to engage in excessive self-promotion on the SunTech Blog. But last month marked the 24th anniversary of SunTech’s first journey into space, and we’d like to let our readers know about this important and interesting chapter in our history. In the pre-dawn darkness of January 12, 1986, the space shuttle Columbia blasted off from launch pad 39A at the Kennedy Space Center, carrying with it a special version of the SunTech Accutracker II ABPM device. When Columbia landed successfully at Edwards Air Force base after 98 orbits, it may have marked the end of mission STS-61C, but it was just the beginning of SunTech’s foray into space-based research.

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Does Your New Physician Make Your Blood Pressure Rise

High Blood Pressure MeasurementA recent article in the Journal of Clinical Hypertension does a colorful yet effective job of describing the transient effects of White Coat Hypertension (WCH) when meeting  a new physician.  Studies show that patients who are not hypertensive but show high BP readings when visiting a new doctor for their first time can continue to present with these elevated BP readings for three to six visits.  Although treatment for hypertension based on these measurements is not recommended, the gold standard diagnostic test for WCH, a 24-hour study with an ambulatory blood pressure (ABP) monitor, can more effectively determine whether treatment is, in fact, needed.

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Implantable blood pressure monitors: Science fiction or reality?

blue waveformAt SunTech Medical, we’re always thinking about blood pressure (BP) and how current measurement tools and techniques might be improved. In many ways, “routine” blood pressure measurement hasn’t changed much over the last 100 years. But innovative tools like ambulatory blood pressure monitoring (ABPM) have helped us learn about the importance of masked hypertension, overnight dipping, and blood pressure variability, their impact on clinical outcomes, and the subsequent guidance of hypertension treatment.

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Correctly Diagnosing High BP In Children: Help Needed!

Child Having His Blood Pressure Measured

(Update 6/10/15: The video referenced in this article is no longer available)

We recently came across a video report that originally appeared shortly after an article on the underdiagnosis of hypertension in children and adolescents was published in the August 2008 issue of the Journal of the American Medical Association (JAMA). The focal point of the report was the fact that 3 out of every 4 children who have high blood pressure have not been correctly diagnosed with the condition. This certainly would prompt the question “Why not?”

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