Phoenix Ambulatory Blood Pressure Monitor Project
Why This is Important
A goal of the Halberg Chronobiology Center is to obtain an Ambulatory Blood Pressure Monitor suitable for long-term use, encourage its use on a massive scale to obtain measures in health, and to encourage the development of diagnostic, preventive and therapeutic techniques. Reliable measurements are important for the correct diagnosis to be made because abnormalities in blood pressure and heart rate are usually asymptomatic until there is target organ damage.
Their data suggest that repeated measurements of blood pressure and heart rate, collected around the clock for a week or longer, can yield a more reliable diagnosis than one based on single measurements as done conventionally: patients who tend to have high blood pressure values in the physician's office due to anxiety would be spared unneeded medication, and patients with high blood pressure at times other than that of the physical examination would be identified and receive the benefit of any needed treatment. This relates in particular to patients who may escape the medication's effect during the night when they are not likely to be seen by a physician.
The assessment of the variability in blood pressure and heart rate also leads to an improved diagnosis, since some abnormalities of the circadian patterns in blood pressure and heart rate are associated with a large increase in cardiovascular disease risk, even when most or all of the measurements are in the acceptable range. By recognizing an elevated risk before there is overt disease, preventive action can be taken, thereby reducing the likelihood of catastrophic disease such as a heart attack, stroke, kidney disease or retinopathy, thereby also reducing health care costs.
When the blood pressure and heart rate measurements are compared with time-specified reference values that are further qualified by gender and age, information is gained regarding the nature and extent of abnormality as well as the timing of its occurrence, so that treatment can be timed to properly target the times of most excess. Treatment can thus be individualized by the timing of its administration. Treatment can also be optimized by specific drug effects affecting the variability of blood pressure and heart rate, quite apart from any effect on their mean value.
Measurements of blood pressure and heart rate and the assessment of their predictable variability (see graph) can be made possible if these variables are measured automatically around the clock for at least 7 days. This is best achieved by means of an automatic ambulatory monitoring device that is easily available for everyone.
About This Page
This page is maintained by Germaine G Cornelissen-Guillaume. It was last updated on 9 August 2004.
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(C) 2004 Germaine G Cornelissen-Guillaume. Copying and distribution of this page is permitted in any medium, provided this notice is preserved.
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