24 hour Blood Pressure Monitor: Everything You Need to Know

The heart is the organ in charge of pumping blood throughout the body, and blood pressure measures the force it uses to pump blood. It contracts to pump blood with each heartbeat and then relaxes to fill up with blood.

Due to this vital function, monitoring blood pressure, especially while engaging in normal daily activities, becomes pertinent. This is because it provides a more accurate understanding of the blood pressure level.

This blog post explains the 24hr blood pressure monitor and everything you need to know.

What is 24 hour blood pressure monitoring?

24hr Blood Pressure Monitor

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The 24 hour blood pressure monitor, or Ambulatory Blood Pressure Monitoring (ABPM), is a diagnostic procedure. It measures blood pressure throughout regular everyday activities for 24 hours to ascertain the presence of hypertension.

And it aids in diagnosing and managing high blood pressure, typically characterized by a systolic pressure of at least 140 mm Hg and a 90 mm Hg diastolic pressure.

The blood pressure monitor can also support a diagnosis of high blood pressure in a clinical environment. This is because many cases of high blood pressure result from patients’ anxiety about going to the doctor.

This situation is often called white-coat hypertension and has been linked to many inaccurate diagnoses.

The device comprises a portable blood pressure meter with an arm cuff and a monitoring device worn on a waist belt. A little tube links the two together. And it is fitted for the patient by either the doctor or other medical practitioner.

It will take your blood pressure every 30 minutes during the daytime and hourly at night. During such times, you will feel the cuff inflate.

At such moments, it is necessary you sit with your arm resting on a level surface like you usually would when your doctor measures your blood pressure.

But this might not always be achievable, depending on what you’re doing now. However, don’t let the monitor interfere with your daily activities.

And after the passage of 24 hours, you are to return the blood pressure monitor to your doctor. Thereafter, your data is analyzed and used to prepare your treatment plan. 

Why Use a Blood Pressure Monitor 24 Hours a Day

Regular blood pressure measurements are done during the ABPM for several reasons. It includes the following:

  • It takes numerous readings instead of one or two during a typical clinic visit, and it mirrors the regular changes in blood pressure.
  • It eliminates the white coat effect.
  • It can identify both masked and sustained hypertension. Masked hypertension is when the blood pressure is normal in the clinic but high during regular activity. While sustained hypertension is when the blood pressure remains high and is linked to an increased risk of heart attacks and renal damage.
  • The blood pressure monitor checks how well your medication manages your high blood pressure. This is because your medication may not control your blood pressure day and night.

So depending on your blood pressure patterns, your doctor may decide to change your dosage and the times you take your medications. Or, to stabilize your blood pressure, you may prescribe more medication.

  • The device determines how blood pressure variations relate to what you do each day and how you sleep.

Your systolic blood pressure typically drops by 10% to 20% when you sleep. This may not be the case, always. Your systolic blood pressure may increase or decrease.

  • It also determines if your blood pressure measurements differ between the doctor’s office and home. These variations are useful in determining the risk level for developing any cardiovascular disease like stroke and heart attack.
  • It reveals whether the blood pressure increases at night or when sleeping and, as such, requires a change in their medical routine.
  • It demonstrates the normotensive effects of current drugs, which shows how they manage blood pressure throughout the day.
  • It produces several metrics, like heart rate, blood pressure, etc. 

With ambulatory blood pressure monitoring, blood pressure variations that could otherwise go unnoticed are identified. And it can be used to determine the various blood pressure trends below:

White coat hypertension

Some people with normal blood pressure at home have increased blood pressure in hospitals. This situation is known as white coat syndrome or white coat hypertension.

It may result in a hypertension diagnosis even when your blood pressure is normal. If the blood pressure monitor is normal outside of your provider’s office, it is not recommended to start treatment.

However, white-coat hypertension could be a sign of high blood pressure. As a result, it should be monitored.

Sustained hypertension

This refers to increased blood pressure readings at home or your healthcare provider’s office. Researchers have linked this condition to a higher risk of stroke, heart disease, and kidney damage.

Masked hypertension

This is a situation whereby your blood pressure is normal when you’re at your doctor’s office but increases when you’re at home. If you have diabetes, kidney disease, or obstructive sleep apnea, you may likely develop masked hypertension.

Nocturnal hypertension

Nocturnal hypertension is when your blood pressure increases when you sleep. Individuals with diabetes or kidney illness are likely to experience it.

How to Perform Ambulatory Blood Pressure Monitoring

At the outpatient clinic, the ABPM monitor is installed for the patient. A cuff that inflates and deflates measures data on a digital monitor.

During the day, readings are obtained every 30 minutes and hourly at night. The cuff is worn the entire time, even when sleeping, as the machine is placed next to them on the bed or under their pillow.

The patient should keep the usual routine to understand better how blood pressure changes throughout daily activities. Avoid activities such as swimming, bathing, or taking a shower for the day so that the machine does not get into wet environments.

The device can retain every reading. Evaluation happens after removal and returns to the clinic. Usually, it beeps before taking readings.

And when this happens, take the following actions:

  • Make a quick inspection to ensure the cuff tube is not curved or bent.
  • If possible, be in a sitting position.
  • The arm with the blood pressure device attached should be raised to the same level as the heart.
  • Keep your arm in a steady position.
  • Avoid talking with people.
  • Make a brief note of the activity being performed at the time of reading, the time of going to sleep and waking up, and any information regarding medicine intake.

As ABPM represents an emotional response, it can cause discomfort in some people, making their readings inaccurate. Due to the possibility that this test may not be helpful for these people, such feelings should be shared with the doctor.

Additional Indications of ABPM

ABPM is equally helpful in the following:

  • Monitoring for hypertension during pregnancy
  • Checking and monitoring borderline hypertension
  • Monitoring fluctuating hypertension.
  • Changing hypertension drugs to track changes in blood pressure due to unresponsive hypertension.
  • It is appropriate in situations such as hypotension or fainting.

Benefits of ABPM

It is a beneficial clinical technique that can aid in ensuring that you receive the best care. The advantages of this type of blood pressure monitor include:

i. Measure your blood pressure accurately.

Instead of only taking your blood pressure once or twice daily, this approach does it continuously for 24 hrs.

Since blood pressure fluctuates, this is an accurate approach to measuring blood pressure and its patterns.

ii. It helps the doctor to disregard insinuations of white coat syndrome

You have white coat syndrome if your blood pressure spikes only when you visit your doctor. Thereby, it helps you avoid taking medicines that are not necessary.

iii. Uncover hidden hypertension

Your average blood pressure is masked if it is low when you visit your doctor’s office but high elsewhere. Only the 24hr blood pressure monitor uncovers this risk factor for cardiovascular disease.

iv. It will help in providing a treatment plan for the patient

This monitoring evaluates the reaction to long-acting hypertensive drugs. And if necessary, your doctor can change your treatment plan.

v. It reduces the chances of developing other illnesses that result from blood pressure

It lowers the risk of heart disease, stroke, and organ damage that could result from hypertension.

Disadvantages of ABPM

Despite being noninvasive, some people may find the 24hr blood pressure monitor uncomfortable. Let’s look at some of the downsides below:

a. Sleep disturbance

A nighttime blood pressure reading could disrupt sleep as one tends to wake up each time the device beeps.

b. It can irritate the skin

The skin may become irritated by the cuff and develop rashes, which usually go away independently.

c. It can lead to soreness of the arm

The wearer may experience pain in the upper arm due to repetitive cuff inflation pressure.

d. It can lead to distraction at work

The routine taking of measurements causes tension in certain individuals and may lead to losing focus at work.


The 24-hour blood pressure monitor helps take continuous blood pressure monitor throughout the day. And it can take readings while you do your daily activities and still gives precise data. It helps verify whether the elevated blood pressure readings at the doctor’s office accurately represent what typically occurs in your body.

And this can assist your doctor in identifying white coat syndrome and treating other blood pressure-related issues.

Uchechukwu Ufoh Kyrian

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