Some people with hypertension may find it strange to know why they need to take 24-hour ambulatory blood pressure when their blood pressure is already high anyway. Is it worth spending so much money? To tell you the truth, 24-hour ambulatory blood pressure monitoring is very meaningful! Here, I would like to first briefly introduce the meaning and testing method of 24-hour ambulatory blood pressure monitoring. 24-hour ambulatory blood pressure monitoring is the use of ambulatory blood pressure recorder to determine a person’s blood pressure value at certain intervals during the 24 hours of day and night, its analysis includes the whole day, day and night systolic blood pressure, diastolic blood pressure, mean arterial pressure, heart rate and their highest and lowest values, blood pressure load value The analysis includes systolic blood pressure, diastolic blood pressure, mean arterial pressure, heart rate and their maximum and minimum values, blood pressure load values, blood pressure variability and circadian blood pressure rhythm. The most commonly used ambulatory blood pressure recorder is the cuff type, which consists of a transducer, a miniature recorder, and a recovery system. The cuff can be inflated at regular intervals to measure brachial artery blood pressure and automatically store the data. Up to 200 blood pressure values can be stored in a day, and then the blood pressure values are printed out by computer analysis. So, why do we need this test? What are the advantages of this test compared to even blood pressure measurement? 1, to help detect “white coat” hypertension: “white coat” hypertension refers to the patient to the hospital, in the doctor’s office to measure blood pressure, blood pressure is elevated, but at home to measure their own blood pressure, blood pressure is normal. This phenomenon of elevated blood pressure upon seeing a doctor may be due to the increased sympathetic nerve activity caused by involuntary nervousness and anxiety when these people see a doctor or nurse in a white coat. The “white coat” hypertension is only a temporary increase in reactive blood pressure, the actual blood pressure is usually at a normal level, so it belongs to pseudohypertension, also known as clinic hypertension. It is possible to distinguish “white coat” hypertension from true hypertension by 24-hour ambulatory blood pressure monitoring, where the patient carries the blood pressure measuring device with him or herself and no medical personnel are present. In clinical practice, it is advisable to perform 24-hour ambulatory blood pressure monitoring in young patients, or in those who are introverted and nervous, before the diagnosis of hypertension is confirmed, in order to exclude “white coat” hypertension. (See hypertension “white coat” phenomenon) 2, help to understand the characteristics of blood pressure fluctuations We know that an occasional blood pressure measurement, provides only a momentary blood pressure, it is difficult to reflect the patient’s blood pressure level at rest or in daily life, more difficult to observe the patient’s blood pressure fluctuations in various physiological or pathological states. For example, pheochromocytoma, which is a secondary hypertension, is clinically characterized by paroxysmal hypertension (sudden rise and fall of blood pressure), and it is difficult to detect hypertensive symptoms if the time of blood pressure measurement coincides with its remission period. The 24-hour ambulatory blood pressure can measure the instantaneous blood pressure of the human body at different times of the day and night, and the data obtained is much more than the occasional blood pressure value, which also far avoids the shortcomings of occasional blood pressure measurement. 3, to help determine the degree of hypertension Currently, it is believed that the assessment of the degree of elevated blood pressure is more important than simply diagnosing hypertension, the higher the ambulatory blood pressure level, the more serious the disease. In other words, in a patient with the same diagnosis of hypertension, one person’s blood pressure exceeds 140/90 mmHg once in 24 hours and reaches 160/100 mmHg, while another person’s blood pressure exceeds 140/90 mmHg 10 times, even though it only reaches a maximum of 150/95 mmHg, making it clear that the latter person’s condition is more severe. This is called a “blood pressure stress value” in ambulatory blood pressure monitoring and is expressed as a percentage of all measurements taken each day when the blood pressure exceeds the standard value. For example, if 135/85 mmHg is the standard upper limit of blood pressure during the day, and if the blood pressure is measured 24 times during the day, and 12 of them exceed 135/85 mmHg, the blood pressure load value is 12/24 = 50%, that is, half of the blood pressure during the day is over the standard, obviously this patient’s blood pressure control during the day is not ideal, and his condition is more serious. 4, to help determine the prognosis: It is generally believed that cardiovascular damage caused by elevated blood pressure is the result of high pressure on the circulatory system for a long time, and the occasional blood pressure measurement does not reflect the average blood pressure level of the individual. 24-hour ambulatory blood pressure measurements correlate significantly better with cardiovascular events than occasional blood pressure measurements, and can be used to predict cardiovascular disease episodes. In addition, those with sudden increases in blood pressure in the early morning are more likely to have cardiovascular events. 5, help guide drug therapy Ideal blood pressure control should include the entire 24-hour blood pressure, ambulatory blood pressure monitoring without “white coat hypertension” and placebo response, can correctly evaluate the treatment process at rest and activity and circadian rhythm and the duration of drug action, according to the blood pressure peak and trough time, can choose the duration of action. It is possible to select antihypertensive drugs with different lengths of action, adjust the dose and duration of administration, and adjust the number of doses and intervals in order to control blood pressure more effectively and reduce adverse drug reactions.