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The special ABPM blood pressure monitor is automatic, lightweight (about 1 pound or less) and quiet. It consists of an arm cuff, a tiny computer and a small compressor to inflate the arm cuff.
The compressor and computer are generally worn on a belt around the waist with a tube leading up to a cuff placed on the upper arm. The monitor is programmed to automatically inflate the cuff at specific intervals during the ABPM period, usually every 15 to 30 minutes. In cases of recurring fainting, measurements may be taken as frequently as every seven to eight minutes.
The frequency of measurements may be programmed differently during the night to minimize the disturbance to a patient’s sleep. The schedule also adjusts for the fact that changes in blood pressure are less dramatic when the patient is at rest.
There are two basic techniques that can be used with the monitor cuff to read a patient’s blood pressure. Some monitors use one or both of the following techniques:
- Auscultation. A microphone in the arm cuff detects the starting and stopping of particular sounds called Korotkoff sounds. Korotkoff sounds are the noises that blood makes as it passes through an artery. These are the same sounds that healthcare professionals listen for with a stethoscope when taking blood pressure readings during an office visit. The pressure at which these sounds start corresponds to systolic blood pressure. The pressure at which the sounds stop is the diastolic blood pressure.
- Oscillation. As the blood pressure cuff inflates, vibrations or fluctuations occur in the cuff’s pressure. These vibrations are called oscillations. The point at which the oscillations first increase corresponds to systolic blood pressure and the pressure at which they stop decreasing is the diastolic blood pressure.
Research has not yet determined which of these two methods produces the most reliable results. The microcomputer stores the information during the ABPM, and it is later retrieved and analyzed with special computer software.
No matter which type of monitor is used, it must first be calibrated to each individual patient. A patient may be asked to hold various positions (e.g. lying, reclining, sitting, standing) for a few moments so this can be accomplished.
Although the monitor is designed to be as unobtrusive as possible, patients will be instructed to keep their arm still and away from loud noises or vibrations during the measurements. For instance, if the patient is walking on a treadmill when the cuff begins to inflate, he or she should stop and turn off the treadmill so that its noise and vibrations do not affect the blood pressure measurement. Once the reading is complete, the patient may resume exercising.
Patients are usually asked to keep a diary or log during the ABPM period. In the log, they should record their physical and mental activities, locations, emotions, medications, eating schedule and more. The log will help physicians interpret the results of the ABPM. For instance, some conditions lead to a dramatic decrease in blood pressure after a meal (called postpradial hypotension). | 
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