Ambulatory Blood Pressure Monitoring

The results are in! In collaboration with Virginia Commonwealth University , Bremo Pharmacy participated in a study to see if it would be feasible to offer patients ambulatory blood pressure monitoring (ABPM) at their local community pharmacy. The study confirmed that it is in fact feasible to offer this service  and we will now offer ABMP to anyone with a referral from their provider at Bremo Pharmacy! 

The program we offer at Bremo Pharmacy is a 24-hour blood pressure monitoring program. The monitor used to measure your blood pressure is non-invasive and it takes your blood pressure at predefined time periods (usually about every 30-45 minutes) through the day and night.

Why do we care so much about offering this program?

  • It is the preferred method for diagnosing high blood pressure (hypertension)
  • It can help to differentiate between true hypertension, white coat hypertension and masked hypertension, which will be discussed further
  • It can also assist with diagnosing hypotension (low blood pressure)

Your healthcare provider can use the data from your 24-hour blood pressure monitoring results to guide how to manage your blood pressure.

What are some good reasons to have my blood pressure monitored for 24 hours?

Ambulatory blood pressure monitoring (ABPM)  can help us better fit together the pieces of your blood pressure puzzle. When you do ABPM we can get a better picture of how your blood pressure fluctuates throughout the day and how this may vary from setting to setting.

  • If you have just been diagnosed with hypertension, it can help your provider navigate the best way to tailor your medication therapy to minimize your exposure to unnecessary medications and get you on your path to optimal blood pressure control.
  • We’re human, sometimes we forget to check our blood pressure regularly, don’t have the required equipment, or we forget to record it and bring in those readings to our appointments for our healthcare providers to review and assess. This program allows for 24 hours  of blood pressure readings for your provider to evaluate.
  • There is a phenomenon known as white coat hypertension, this when your blood pressure is higher in a medical setting, such as a doctor’s office. Monitoring your blood pressure over a 24 hour period will allow us to see if you have this.  
  • In other people they may have masked hypertension, meaning their blood pressure readings are fine at the doctor’s office, but their blood pressure may increase at other times of the day or in different settings. A 24 hour blood pressure monitoring program can help your provider identify if this is applicable to you.
  • If you have been taking 3 or more blood pressure medications, but have yet to meet your blood pressure goals, 24-hour blood pressure monitoring can help us narrow in on potential issues throughout the day and tailor your therapy accordingly.

More and more research is coming out to say that your 24-hour blood profile, especially your night-time blood pressure, predicts your cardiovascular risk better than your office-based blood pressure readings (1,2.)

Potential outcomes that you and your provider may consider after your 24-hour blood pressure monitoring results

  • Optimize your medication therapy to minimize your risk for side effects like hypotension
  • Replace a medication in your regimen to better target your blood pressure concerns
  • Reduce the number of medications needed to keep your blood pressure under control
  • Give you a more accurate diagnosis of your white coat or masked hypertension

Medications should never be started, stopped or changed without instruction and counseling of a healthcare professional.

Ok, I’m in, so now what?

Consult with your primary care provider or cardiologist, ask them to fill out the referral form from Bremo Pharmacy and send it to us. We will reach out to you to schedule a visit. At your visit we will do an intake with you and set you up with the monitor. After the 24-hour monitoring period you will return the device back to the pharmacy. When you return the device, a report of your blood pressure over the 24 hour time period along with an interpretation and recommendations will be sent to your provider.

What is the cost of ABPM with Bremo Pharmacy and what does my fee cover?

The cost will be $50 and covers all of the following:

  • Education with our team on 24-hour blood pressure monitoring
  • Device set up at the pharmacy
  • Retrieval of your results
  • Communication with your referring provider

A Success Story

An older woman who was on several blood pressure medications was concerned about low blood pressure symptoms (dizziness, blurred vision, tiredness and unsteadiness), but her provider was hesitant to reduce the number of blood pressure medications she was taking because of her history of elevated readings. She was referred for ABPM and her 24-hour blood pressure report showed that her average BP was below normal with a lot of dips through the day. This meant that she was in fact hypotensive. Her blood pressure medication regimen was doing its job, but more than was necessary. Seeing the report allowed the provider to stop some of her medications and minimize her risk for side effects associated with low blood pressure, including falls.

 

References

  1. Fagard, RH., HA Celis, LL. Thijs, et al. “Daytime and Nighttime Blood Pressure as Predictors of Death and Cause-Specific Cardiovascular Events in Hypertension.” Hypertension 51.1 (2008): 55-61.

Palatini, R, Beilin, C, Eguchi, I, et al. “Added Predictive Value of Night-Time Blood Pressure Variability for Cardiovascular Events and Mortality: The Ambulatory Blood Pressure–International Study.” Hypertension 64.3 (2014): 487-93

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