Table of ContentsView AllTable of ContentsWhat Is an ABPM?Interpreting ABPM ResultsWhen Is ABPM Used?Are ABPMs Accurate?ABPM CostsHow to PrepareFrequently Asked Questions
Table of ContentsView All
View All
Table of Contents
What Is an ABPM?
Interpreting ABPM Results
When Is ABPM Used?
Are ABPMs Accurate?
ABPM Costs
How to Prepare
Frequently Asked Questions
Ambulatory blood pressure monitors (ABPMs) are widely used to assess blood pressure in real time.ABPMs allow healthcare providers to assess your blood pressure during your routine activities in daily life, whether working, sleeping, or doing chores.
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What Is an Ambulatory Blood Pressure Monitor?
Ambulatory blood pressure monitoring is accomplished with a special device that consists of a blood pressure cuff worn on your arm. It’s attached to a small recording device that you wear on your belt.
You wear the ABPM device for 24 hours. Throughout that period, it records your blood pressure, typically at 15-minute or 30-minute intervals, during your routine daily activities and while you are sleeping. The ABPM provides your healthcare provider with a complete record of your blood pressure, which fluctuates (changes) throughout the day and night.
A blood pressure reading taken in a healthcare provider’s office records a single value while you’re at rest. The ABPM information tracks your blood pressure in real time.
The ABPM does not report merely a single value forsystolic and diastolic blood pressurethat supposedly represents your official “blood pressure.” Instead, it reports an entire range of (often) widely variable values throughout the course of a day or longer.
What Is the Difference Between HBPM and ABPM?
Should I Be Concerned About Fluctuating Blood Pressure?
How Do You Measure Ambulatory Blood Pressure?
Using the ABPM to diagnosehypertension(high blood pressure) requires a different approach to interpreting your blood pressure recordings.
After wearing the ABPM device for 24 hours, you will follow up with your healthcare provider to review the results, which will include:
Hypertension is diagnosed when average blood pressure exceeds one or more of the following values using ABPM:
Normal blood pressure of 120 mmHg over 80 mmHg does not change with an ABPM, but it is based on averages.
There are several situations when ABPMs can be a valuable device for discovering high blood pressure.
White Coat Hypertension
While high blood pressure readings taken in a healthcare provider’s office may truly indicate hypertension is present, sometimes that is not the case. ABPM is helpful in assessing people with white-coat hypertension, which is elevated blood pressure in a healthcare office with normal out-of-office blood pressure values.
Sustained Hypertension
Sustained hypertension is diagnosed when blood pressure readings are high in both the ambulatory setting and the healthcare office setting.The ABPM confirms that high blood pressure is present all of the time, not just in the healthcare setting.
Masked Hypertension
Masked hypertension is described as high ambulatory blood pressure with normal blood pressure measurements in the healthcare provider’s office.It is estimated that masked hypertension occurs in 10% to 30% of people.Without the use of an ABPM, this type of high blood pressure may not be discovered.
Nocturnal Hypertension
Nocturnal hypertension is diagnosed when nighttime systolic blood pressure readings are above 120 mmHg or diastolic blood pressure is above 70 mmHg.Normally, blood pressure decreases at night, and most people only have blood pressure measured during the day, so the ABPM is a valuable tool for discovering this type of hypertension.
Other Uses for ABPM
Some people have wide fluctuations in blood pressure and ABPM can help with a difficult diagnosis. It’s also useful to investigate whether existinganti-hypertensive medicationsare working, or why they’re not effective.
ABPM can help in the diagnosis and treatment of some forms ofdysautonomia—anautonomic nervous systemdisorder that can lead to intermittent and unpredictable episodes of very low blood pressure.
Ambulatory blood pressure monitors have been tested for accuracy for almost two decades. ABPM devices have been shown to be accurate enough for routine clinical use in a variety of patients.
Accuracy in making a diagnosis of hypertension depends upon obtaining repeated blood-pressure measurements. Using ABPM devices makes this more practical. Because of the limitations of repeated in-office blood pressure measurements and inaccuracies using home blood pressure measurements, the American Heart Association recommends 24-hour ambulatory blood pressure monitoring (ABPM) as a preferred method to diagnose hypertension.
ABPM Costs and Availability
In most cases, an ambulatory blood pressure machine is provided through your healthcare provider or a specialized hypertension center.They are used as part of an ABPM exam. The devices cost between $2,000 and $2,500, even for a primary care practice to acquire.
Usually, you will use one under the healthcare provider’s direction. That means the provider will give it to you for short-term use at a cost of $200 to $250. Keep in mind that insurance companies may approve its use only for certain conditions. The reimbursement rates also will vary, so check with your insurance provider for details.
Although less common, ABPM rental may be available through a pharmacy or clinic near you.
ABPM Certification
How Do You Prepare to Use an ABPM?
You wear the ABPM device in daily life, so there’s not too much preparation. Some general tips include:
There are a few activities you need to avoid. During this 24-hour period, you shouldn’t:
How to Sleep With an ABPM
It may be difficult to sleep since you’re not used to having a blood pressure cuff inflate on your arm during the night. Your healthcare provider will tell you whether you can adjust your equipment while you sleep and may suggest ways to get the best quality sleep.
Try to make your sleep environment as comfortable as possible, such as:
The 6 Best Blood Pressure Monitors to Use At Home, Tested and Reviewed
Summary
Ambulatory blood pressure monitoring is a way of assessing a person’s blood pressure during their routine daily activities and during sleep. This measurement is often more accurate than those taken in a healthcare office.Ask your provider if you have questions about ABPM.
Learn MoreWearable Health Devices
Normal blood pressure of 120 mmHg over 80 mmHg is the same as it is when taken with a cuff, or with a home blood pressure monitoring (HBPM) machine.The difference is that the ABPM averages the pressure across a 24-hour period. It also averages active and sleeping-hour pressures separately.Learn MoreBlood Pressure Chart With Readings By Age and Sex
Normal blood pressure of 120 mmHg over 80 mmHg is the same as it is when taken with a cuff, or with a home blood pressure monitoring (HBPM) machine.The difference is that the ABPM averages the pressure across a 24-hour period. It also averages active and sleeping-hour pressures separately.
Learn MoreBlood Pressure Chart With Readings By Age and Sex
13 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Nobre F, Mion Junior D.Ambulatory Blood Pressure Monitoring: Five Decades of More Light and Less Shadows.Arq Bras Cardiol. 2016 Jun;106(6):528-37. doi:10.5935/abc.20160065.Islam MS.Ambulatory Blood Pressure Monitoring in the Diagnosis and Treatment of Hypertension.Adv Exp Med Biol. 2017;956:109-116. doi:10.1007/5584_2016_177Shimbo D, Abdalla M, Falzon L, Townsend RR, Muntner P.Role of Ambulatory and Home Blood Pressure Monitoring in Clinical Practice: A Narrative Review.Ann Intern Med. 2015 Nov 3;163(9):691-700. doi:10.7326/M15-1270.O’Brien E, White WB, Parati G, Dolan E.Ambulatory blood pressure monitoring in the 21st century.J Clin Hypertens (Greenwich). 2018;20(7):1108-1111. doi:10.1111/jch.13275Nuredini G, Saunders A, Rajkumar C, Okorie M.Current status of white coat hypertension: where are we?Ther Adv Cardiovasc Dis. 2020;14:1753944720931637. doi:10.1177/1753944720931637Trudel X, Brisson C, Gilbert-Ouimet M, Vézina M, Talbot D, Milot A.Long working hours and the prevalence of masked and sustained hypertension. Hypertension. 2020;75(2):532-538.doi:10.1161/HYPERTENSIONAHA.119.12926O’Brien E, Parati G, Stergiou G, et al.European Society of Hypertension position paper on ambulatory blood pressure monitoring[published correction appears in J Hypertens. 2013 Dec;31(12):2467].J Hypertens. 2013;31(9):1731-1768. doi:10.1097/HJH.0b013e328363e964Goldberg L, Bar-aluma BE, Krauthammer A, Efrati O, Sharabi Y.Ambulatory blood pressure profiles in familial dysautonomia.Clin Auton Res. 2018;28(4):385-390. doi:10.1007/s10286-018-0507-1Townsend RR.Out-of-office blood pressure monitoring: a comparison of ambulatory blood pressure monitoring and home (Self) monitoring of blood pressure. Hypertension. 2020;76(6):1667-1673. doi:Unnikrishnan S, Awadhiya O, Lahiri A, Pakhare AP, Joshi A, Joshi R.Accuracy of Short-Term Ambulatory Blood Pressure Measurements for the Diagnosis of Hypertension.Cureus. 2021;13(9):e17871. Published 2021 Sep 10. doi:10.7759/cureus.17871American Academy of Family Physicians.Five steps to set up ambulatory blood pressure monitoring in your practice.Krakoff LR.Ambulatory blood pressure improves prediction of cardiovascular risk: implications for better antihypertensive management.Curr Atheroscler Rep. 2013;15(4):317. doi:10.1007/s11883-013-0317-9American Heart Association.Monitoring your blood pressure at home.
Nobre F, Mion Junior D.Ambulatory Blood Pressure Monitoring: Five Decades of More Light and Less Shadows.Arq Bras Cardiol. 2016 Jun;106(6):528-37. doi:10.5935/abc.20160065.
Islam MS.Ambulatory Blood Pressure Monitoring in the Diagnosis and Treatment of Hypertension.Adv Exp Med Biol. 2017;956:109-116. doi:10.1007/5584_2016_177
Shimbo D, Abdalla M, Falzon L, Townsend RR, Muntner P.Role of Ambulatory and Home Blood Pressure Monitoring in Clinical Practice: A Narrative Review.Ann Intern Med. 2015 Nov 3;163(9):691-700. doi:10.7326/M15-1270.
O’Brien E, White WB, Parati G, Dolan E.Ambulatory blood pressure monitoring in the 21st century.J Clin Hypertens (Greenwich). 2018;20(7):1108-1111. doi:10.1111/jch.13275
Nuredini G, Saunders A, Rajkumar C, Okorie M.Current status of white coat hypertension: where are we?Ther Adv Cardiovasc Dis. 2020;14:1753944720931637. doi:10.1177/1753944720931637
Trudel X, Brisson C, Gilbert-Ouimet M, Vézina M, Talbot D, Milot A.Long working hours and the prevalence of masked and sustained hypertension. Hypertension. 2020;75(2):532-538.doi:10.1161/HYPERTENSIONAHA.119.12926
O’Brien E, Parati G, Stergiou G, et al.European Society of Hypertension position paper on ambulatory blood pressure monitoring[published correction appears in J Hypertens. 2013 Dec;31(12):2467].J Hypertens. 2013;31(9):1731-1768. doi:10.1097/HJH.0b013e328363e964
Goldberg L, Bar-aluma BE, Krauthammer A, Efrati O, Sharabi Y.Ambulatory blood pressure profiles in familial dysautonomia.Clin Auton Res. 2018;28(4):385-390. doi:10.1007/s10286-018-0507-1
Townsend RR.Out-of-office blood pressure monitoring: a comparison of ambulatory blood pressure monitoring and home (Self) monitoring of blood pressure. Hypertension. 2020;76(6):1667-1673. doi:
Unnikrishnan S, Awadhiya O, Lahiri A, Pakhare AP, Joshi A, Joshi R.Accuracy of Short-Term Ambulatory Blood Pressure Measurements for the Diagnosis of Hypertension.Cureus. 2021;13(9):e17871. Published 2021 Sep 10. doi:10.7759/cureus.17871
American Academy of Family Physicians.Five steps to set up ambulatory blood pressure monitoring in your practice.
Krakoff LR.Ambulatory blood pressure improves prediction of cardiovascular risk: implications for better antihypertensive management.Curr Atheroscler Rep. 2013;15(4):317. doi:10.1007/s11883-013-0317-9
American Heart Association.Monitoring your blood pressure at home.
Piper MA, Evans CV, Burda BU, et al.Diagnostic and Predictive Accuracy of Blood Pressure Screening Methods With Consideration of Rescreening Intervals: A Systematic Review for the U.S. Preventive Services Task Force. Ann Intern Med 2015; 162:192.
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