The blood pressure holter is a diagnostic tool that allows precise monitoring, as part of normal life, of blood pressure by taking several measurements over 24 hours. More complete than a simple blood pressure test, this test, prescribed by the cardiologist or the attending physician, is intended to control its variations (hypo or hypertension). It can also be used to check the effectiveness of hypertensive treatment. In this article, discover all the answers to your questions on the role and operation of a blood pressure holter, as well as practical advice to know when using it at home.

The blood pressure holter is a recording device, consisting of a compact case, worn over the shoulder, and connected by a wire to a cuff. This is supplied with software for presenting the results.

Prescribed by the cardiologist or the attending physician, the blood pressure holter allows the ambulatory measurement of blood pressure, also called ABPM, every 20 to 45 minutes, for an extended period, usually 24 hours.

Examining with a blood pressure holter is useful for people with variable blood pressure. In this context, the doctor can detect in particular:

• a nocturnal hypertension, otherwise undetectable, and a sign of severe hypertension ;
• potentially dangerous episodes of hypotension in patients treated with antihypertensive drugs.

Completely painless, the installation of a blood pressure holter is done in a few minutes and does not require any prior preparation. The inflatable pressure cuff is placed on the less active arm, namely the left arm for right-handed people and the right arm for left-handed people. The cuff is then connected to a programmable automatic recording device, which will automatically record and store all the data relating to the blood pressure measurements taken during the day. In the event of an incorrect measurement, the device can trigger a second automatic measurement which allows better results to be obtained. The results are not displayed but saved in the case, usually attached to the belt. It is advisable to go about your usual business so that the recording takes place in conditions as close as possible to everyday life.

Precautions for use

• Make sure that the case does not receive shocks and does not get wet;
• Do not take a bath or shower during the recording period;
• Stretch and keep the arm still each time the cuff inflates to allow reliable blood pressure measurement;
• Note the different events of the day (wake-up, meals, transport, work, physical activity, tobacco consumption, etc.);
• With a mention of the schedule of medication in case of treatment;
• Wear clothes with wide sleeves;
• Place the device next to you at night.

Cell phones and other devices do not interfere with the proper functioning of the device.

The data collected is interpreted by a cardiologist and the results are sent to the attending physician or are given to the patient directly during a consultation.

Interpretation of the results takes place quickly after the case has been collected by the medical team. A digital medium allows the recording of data. These are then transcribed in the form of graphs making it possible to visualize at what time of the day the heart rate accelerated or slowed down. The cardiologist then analyzes the blood pressure averages:

• daytime: the home norm must be less than 135/85 mmHg;
• nocturnal: this must drop by at least 10% compared to the daytime blood pressure, that is to say be less than 125/75 mmHg.

Depending on the patient’s daily activities and the blood pressure averages observed each hour, the cardiologist can then re-evaluate the treatments if necessary.