Ambulatory monitoring of the blood pressure

The Ambulatory Monitoring of the Blood Pressure (usually called MAPA ) is an apparatus making it possible to measure the blood Pressure in a way repeated during 24:00

It is sometimes wrongfully called Holter tensionnel referring thus to the holter of the electrocardiogram, the " term; holter" coming from the name of the doctor having invented this last system but which forever worked on the blood pressure.

Equipment

It consists of a inflatable arm-band connected by a flexible tube to a portable pump on batteries, a Manomètre and an electronic storage system of the data.

It is positioned on the arm of the patient, the numerical block pump-pressure gauge-storage, in the form of a small case, being slung.

It is regulated to measure the blood pressure several times per hour the day (two to three times in general) and a little less often the night (once per hour). An aural signal informs the patient of the beginning of swelling of the arm-band, the incentive to slacken its arm in order to obtain a reliable measurement. In the event of failure of the latter, one or more new attempts can start. The aural signal is inhibited the night.

Results obtained

At the end of 24:00, the MAPA is taken down of the patient and the case connected to a computer (sometimes directly with a printer). One can obtain as follows:

the whole of the measurements of systolic, diastolic and average pressure, classified by chronological order;
the heart rate with each measurement;
averages on the 24:00, the day and the night of various measurements.

The results can be presented in form:

of raw data;
of histograms according to time.

Utility

The catch of the blood Pressure remains primarily specific in time. Its measured level thus prejudges badly what occurs in the everyday life.

The MAPA thus makes it possible to better apprehend the figures tensionnels and to differentiate a arterial Hypertension permanent of an unstable arterial hypertension, only found during the consultation and being able to be secondary with the stress caused by the latter ( Effet “white blouse” )

The MAPA also makes it possible to classify certain hypertensions and to evaluate severity of it (for example, the absence of fall of the figures during the sleep is a pejorative criterion).

The MAPA makes it possible, in the same way, to better evaluate the effectiveness of a treatment.

This examination is however in competition with the tensionnelle automesure where the patient has his own automated tensiometer what enables him to measure in a repeated way its tension.

Reference

24-hour ambulatory blood presses monitoring , O' Shea JC, Califf, Am Heart J. 2006 May; 151 (5): 962-8

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