Ambulatory blood pressure monitoring (ABPM) is becoming increasingly popular in general practices to diagnose and control hypertension. The technique is more expensive than conventional blood pressure measurement (CBPM), but the benefits for patients justify additional expenses, and it is also approved for reimbursement.

Reimbursement is a critical consideration when incorporating ABPM into your practice. It is not well-known that ABPM pays for itself because it is both reimbursable by Medicare and private insurance providers. Reimbursement rates range from $50 to $300, depending on patient conditions (which are described by reimbursement codes), insurance company policies and geography.

Complications of hypertension account for nearly 9.5 million deaths worldwide in a year. The WHO Health 2020 policy identifies hypertension as the world’s most prevalent preventable disease.

Ambulatory blood pressure monitoring provides information over and above conventional blood pressure measurements.

ABPM advantages:

• It gives more measurements than CBPM. Therefore, real blood pressure is reflected more accurately.
• It helps to avoid the effect of white coat hypertension when the patient’s blood pressure rises in the medical environment only.
• It operates for 24 hours. Therefore, it also records nighttime blood pressure, a major cardiovascular risk indicator.
• It lowers the chance of misdiagnosis.
• It makes drug treatment more efficient.

Choosing an ABPM monitor

Focus on accuracy. The Association for the Advancement of Medical Instrumentation (AAMI) and the British Hypertension Society (BHS) published a standard which included a protocol for the evaluation, and precision of ABPM devices. Select an ABPM, which has been evaluated according to one or both protocols.

Choosing an ABPM software

Each ambulatory blood pressure monitor is available with a software package, which displays and presents recorded data in a variety of ways. A busy general practice may need only a blood pressure chart with day-night statistics while a researcher may require more detailed information such as hypertension load, percent time elevation, day/night index or morning surge.