What Patients Do While Receiving a 24 Hours Ambulatory Blood Pressure Monitoring
DOI: 10.3238/zfa.2017.0156-0160german translation / full article
Background: Patients are often asked to complete a protocol-sheet during the period of ambulatory blood pressure monitoring (ABPM). This study analyzes a few ten thousand single data of blood pressure and corresponding protocols combined what has not been done so far following the publications. The aim was – afar of the individual advantage – to characterize systematic interrelations of the protocols, blood pressure and ABDP, e.g. which activities are recorded and how thoroughly, which activities boost blood pressure or do ABPM-days paint a realistic picture of blood pressure course?”
Methods: We gathered 465 ABP-recordings with a daily mean BP of 135/90 mmHg or higher, retrospectively collected from 13 family practices. Age, gender, recorded activities and their duration together with BP were computed with MS-Excel.
Results: Out of 465 protocols, 250 were completed to a minimum of 80 %. The average patient was 55,6 years old (SD 14,5), 42,9 % were female. Mean daily BPs displayed the first degree of WHO BP-grading, nightly BPs were in the upper normal range. Sleeping, meals, television, resting were the occupations mentioned most frequently. The longest time period was occupied by sleeping (7:52), followed by professional occupation (5:28), television (2:47), housework (2:24) and desk work like computing and writing (2:22) [hours]. During most of these activities BPs stayed in normal range for at least 50 % of the time, much longer during times of sleep or rest. During a quarter of the time, the results displayed higher BPs.
Conclusions: Patients’ activity-protocols are often not thoroughly completed. Domestic activities appear to fill their days. Compared to the average occupational workload in Germany, patients worked 2.5 hours less on ABPM-days. Systematically low BP-values could result when activity is reduced in such a way during ABPM. Physicians and their staff should therefore advise patients to fill in each protocol for ABPM thoroughly and to choose an average day with typical activities.