Why is 24-hour blood pressure monitoring recommended?
Your blood pressure changes throughout the day. Physical activity, stress, rest and sleep can all affect it. Your blood pressure may also be higher at the GP practice than it is at home. This is known as the ‘white-coat effect’.
The GP or practice nurse may recommend 24-hour blood pressure monitoring:
- if your blood pressure has been raised several times at the practice;
- if your blood pressure varies considerably;
- if measurements taken at home and at the practice are different;
- to assess how your blood pressure changes during the day and while you sleep;
- to check whether your blood pressure medication is working properly;
- if you have symptoms that may be related to high or low blood pressure.
How does the test work?
A blood pressure cuff is fitted around your upper arm. A tube connects the cuff to a small portable monitor, which you wear on a belt around your waist or carry in a small pouch.
The monitor automatically inflates the cuff and measures your blood pressure for 24 hours. Measurements are usually taken more frequently during the day than at night. All measurements are stored in the device.
When the cuff inflates, your arm may temporarily feel tight or tingly. This should disappear when the cuff deflates. The sound and inflation of the cuff may occasionally disturb your sleep.
During the monitoring period
Try to continue your normal daily activities as much as possible. This allows us to obtain a representative picture of your blood pressure during an ordinary day.
Please follow these instructions:
- Keep your arm relaxed and still when the cuff starts to inflate.
- If possible, let your arm hang loosely by your side or rest it comfortably.
- Check that the cuff is still positioned correctly if the device repeatedly tries to take a measurement.
- Keep the monitor and cuff dry. You cannot shower, bathe or swim while wearing the device.
- Do not disconnect the tube between the cuff and the monitor.
- Do not switch off the device yourself.
- Take your medication as usual, unless the GP has advised you otherwise.
- Wear loose-fitting clothing with enough room for the blood pressure cuff.
It does not matter if an occasional measurement is unsuccessful. The device will usually try to take the measurement again automatically.
Diary
You may be given a diary in which to record relevant information during the monitoring period. Please write down as accurately as possible:
- what time you get up and go to bed;
- when you take your medication;
- when you are physically active, for example while working, cycling, exercising or doing housework;
- when you rest or sleep;
- when you experience symptoms such as dizziness, headache, palpitations or feeling light-headed;
- any unusual events, such as stress, tension or strong emotions.
This information helps the GP interpret any unusual blood pressure readings.
After the monitoring period
After approximately 24 hours, you return the blood pressure monitor to the practice. The stored measurements will then be downloaded and reviewed.
The GP or practice nurse will assess:
- your average daytime blood pressure;
- your average blood pressure during the night;
- changes and variations in your blood pressure;
- whether your blood pressure falls sufficiently while you are asleep.
The results will be discussed with you during a follow-up appointment. Depending on the results, no treatment may be necessary, further monitoring may be advised, or your treatment may be started or adjusted.
When should you contact the practice?
Please contact the practice if:
- the cuff or monitor becomes detached and you cannot reconnect it;
- the cuff does not deflate;
- you experience persistent pain, numbness, discolouration or loss of strength in your arm;
- the device no longer appears to be working.
Call 112 immediately if you develop severe or sudden symptoms, such as chest pain, severe shortness of breath, facial drooping, weakness in an arm or leg, or difficulty speaking.
More information
More general information about measuring and treating high blood pressure is available in Dutch on Thuisarts.nl – Mijn bloeddruk is te hoog.
