24 hour blood pressure measurement

By the many, over the day and the night measurements distributed (during the day, at night) every 15 minutes every 30 minutes the ambulatory 24 hour measurement offers advantages over the only physician measurement:
  • More exact classification of hypertension sick persons and uncovering of a doctor's office hypertension.
  • Uncovering of a disturbed day-/ night rhythm and screening improved therefore on a secondary hypertension.
  • Improved assess the individual cardiovascular risk.
  • Therapy monitoring improved (avoidance of about or sub-medical treatment; also at night.
Only apparatuses should be used as in the case of the opportunity measurement and self measurement, the accuracy criterions of an established protocol have fulfilled these (see above). At least 21 meaningful measuring of the systolic and diastolic blood pressure and at night at least 12 meaningful measuring should be recorded during the day. If too few measurements are lifted up, the monitoring should be repeated.

The German league for the fighting the high blood pressure has as an upper norm limit for the day mean average value (e.g. 7 a.m. to 10 p.m. of 135/85 mmHg fixed. The classification as "hypertension ill" is carried out with this value. Hydrogen mean ave rage value is 120/75 mmHg A flat to upper standardize limit for 130/80 mmHg, for The night mean ave rage value for 24. should < 25% during the day, night s < 20% of the measured values are among 140/90 mmHg. The night or a blood rise in pressure is striking and should be clarified a sink around less than 10% in. Principle would be desirable that every hypertension's patient gets once a 24 hour measurement at least to check the day- night rhythmic.

The 24 hour blood pressure measurement before the beginning of a therapy is always indicated then if:
  • There is Insists are discrepancy between of The height of The opportunity blood pressing aurochs and of The extent of The organ damages (practice hypertension) and therefore the suspicion of a White coat hypertension;
  • Greater differences (> 20/10 mmHg) between the blood pressure values being watched at the self measurement and at the physician measurement,
  • In the night or a rhythm lifted there is a good chance for increased blood pressure values,
  • You must search after crisis-prone blood pressure increases.
The blood pressure usually shows a rhythmic with the highest values in the morning, a second peak in the late afternoon and a waste of the systolic mean average values to 15% the diastolic to 20% lasting in the sleep the night around 10 around 15. Exogenous factors, e.g. shift-work, can modify this rhythmic. A missing blood pressure drop during the night sleep or even a blood rise in pressure is watched sleep apnea, nightly asthma bronchial and or renal transplantation at a secondary hypertension as well as at patients with renal (kidneys) after heart, cerebrovascular (brain vessels) or cardiac (heart) hypertension complications at pregnancy hypertension.

The long time blood pressure measurement under an existing therapy should always be then carried out if:
  • Despite apparently adequate therapy the reduction in the opportunity blood pressure in the practice and the blood pressure values self-measured is insufficient,
  • The successful reduction in increased blood pressure values must be checked in the nightly sleep phase,
  • The involution of organ damages after 6-12 months despite a good attitude of the opportunity blood pressure is missing,
  • Side effects e.g. dizziness being suspected by excessive hypotensions which cannot be cleared by opportunity and self measurements.
A day as representative as possible is required for the 24 hour measurement, i.e. in the rule it is taken on working day. For the assignment of the parameters to different activities, experiences and to the medicine intake a protocol which should be executed during the scheduled 20-minute measuring intervals is necessary. Should get up, go to bed with a correct time quotedly be, taking of antihypertensives and other relevant events


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