Abstract
Ambulatory blood pressure measurement (ABPM) is the gold-standard method for blood pressure assessment. However, it is markedly underutilized, in part because legacy software provided with ABPM devices is archaic and inefficient. Herein, we illustrate an example of a recently developed cloud-based ABPM platform. Such a platform offers several distinct advantages: (1) the ability to guide users through the testing process; (2) synchronizing inputs of the technician, patient, physician, and administrative assistant so that testing can be successful and efficient; (3) providing guideline-concordant study interpretations that can be e-signed, reducing physician interpretation times; (4) enabling central expert oversight and peripheral deployment of testing, thereby increasing accessibility of quality testing; and (5) facilitating integration into electronic medical records, improving dissemination of results. It is envisioned that increased use of cloud-based ABPM platforms will lead to the expansion of quality ABPM testing, thus improving the care of patients with known or suspected hypertension.
Highlights
There is a need for standardization of Ambulatory blood pressure measurement (ABPM) measurement procedures, which includes standardization of how data are shared between referring physicians and sites running
The need to share data in a uniformly accepted format is of particular relevance given how the COVID-19 pandemic resulted in lockdowns and restriction of physical mobility and inperson clinical assessments, underscoring the necessity for robust virtual data sharing systems[28,29]
A cloud-based, tablet-deployed solution has many benefits that enable efficient test delivery in a guidelineconcordant manner. Such a platform can address the requirement that multiple individuals contribute to a successful ABPM test, by protocolizing, automating, and synchronizing multi-user contributions in the cloud and in a manner that increases the efficiency of testing in a manner consistent with best practice
Summary
High blood pressure (BP) or hypertension is the leading cause of death and disability globally, affecting one-. White coat hypertension in untreated patients, or white coat effect in treated patients, is present when clinic BP is elevated, and ABPM is normal It has a prognosis similar, perhaps slightly worse, than true normotension, and current recommendations are that drug therapy not be initiated or up-titrated[2-5]. Masked hypertension (untreated patients) or masked effect (treated patients) occurs when clinic BP is normal, and ABPM is elevated[14] The presence of this phenotype portends increased cardiovascular risk, similar to uncontrolled hypertension, and the current consensus is that treatment should be initiated or up-titrated[2-5]. In the United States (US), depending on the population being studied, whether publicly insured Medicare beneficiaries or commercially insured members, use of ABPM is woefully low, at 0.1%0.3% of eligible patients[16,17] These may vary across jurisdictions, but typically include the following: 1. Clinics wishing to invest in multiple units to start a program face significant initial costs
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