AMBULATORY BLOOD PRESSURE MONITORING: ADVANTAGES AND OPPORTUNITIES

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Objective: Ambulatory Blood Pressure Monitoring (ABPM) is a procedure used to diagnose hypertension, detect white-coat effect, masked hypertension and monitor blood pressure (BP) control. It offers additional and important data in opposite to office BP, such as the dipping status and circadian variability of ambulatory BP, and it is a better predictor of cardiovascular outcomes and morbid or fatal events. In our country, ABPM has limited availability in Primary Health Care. With that in mind, the health care team of our Primary Health Care Unit created an ABPM protocol in August 2017 in order to provide this procedure to its patients. Design and method: Descriptive, cross-sectional and observational study. Data collected from August 2017 to December 2019 regarding the results of ABPM and patient data. The ABPM protocol was designed following the most recent European Society of Hypertension guidelines. Results: In the described period, our unit performed 136 ABPM exams. The average age of patients submitted to ABPM was 53 years and 54% were of the male gender. The majority (67%) were referred for diagnosis purposes and 33% to monitor BP control. With the ABPM protocol we were able to diagnose 60 patients with sustained hypertension and 36 patients with uncontrolled hypertension, from which 10 presented resistant hypertension. Regarding the dipping status, 55% were dipper, 23% extreme dipper, 19% non-dipper and 3% reverse dipper. In 63% of cases, the ABPM results led to direct clinical decision-making by the family physician, such as pharmacology intervention, clinical investigation and lifestyle advice. Conclusions: Overall the ABPM is an accurate, cost-effective protocol that provides important information for the prediction of cardiovascular risk. Consequently, ABPM protocol implementation has been observed to have a direct positive impact in the diagnosis, monitoring and clinical decision-making ability of the physician regarding hypertension. With this presentation we wish to share the positive impact of ABPM usage on our Health Care Unit and to inspire and motivate others to create a similar protocol.