The tensional holter (or MAPA), how is it?
How's it going ?
As in the office, you put on an armband for the exam. The difference ? This is done for a period of twenty-four hours (at the cardiologist, clinic or hospital departments dedicated to hypertension) and connected to a housing the size of a mobile phone. The device is programmed to trigger the cuff every fifteen minutes during the day and every fifteen to thirty minutes at night, so as to take up about fifty measurements in all. At each check, you have to reach out. In case of failure, the device takes a value immediately. The results are not displayed (voluntarily) but saved in the case, usually attached to the belt.
It's used for ?
Prescribed by the cardiologist or the treating physician, this exam is the best method of measuring blood pressure, the Rolls-Royce of the diagnosis of hypertension. It is also an excellent tool for therapeutic evaluation to better adjust the treatment of hypertensive patients. Because this twenty-four hour follow-up gives many indications that it does not allow the measurement of the tension in the office, often higher than normal because of the effect "white coat" (it would affect one elderly person out of two), and which sometimes leads to inappropriate treatments. The ABPM almost continuously monitors the patient's tension at different times of the day (in activity, after a meal ...) and at night. It can thus reveal potentially dangerous episodes of hypotension in the elderly (linked to an overflow of drugs) or night-time hypertension, otherwise undetectable, and sign of the severity of the arterial hypertension.
Not even scared, not bad
The examination is certainly binding. It forces to keep the armband a day and a night while maintaining its usual activities (this is the interest), except ... the shower, to be absolutely prohibited! Totally painless, it can - especially in the elderly - bring out small bruises. During commissioning, the nurse explains how to reposition it if it is too tight and has a tourniquet effect.
There are not any. On the other hand, during the entire examination, it is important for the patient to note his activities of the day (awakening, meals, transportation, work, physical activity, smoking, taking medication ...) fine analysis of events.
And after ?
The interpretation of the results takes place quickly after the recovery of the case. The cardiologist will analyze the average of the diurnal arterial pressure (the norm at home must be inferior to 135/85 mmHg) and nocturnal (it must decrease by at least 10%, ie be lower than 125/75 mmHg). Depending on the activities of the patient's day and the averages of tension observed each hour, he will be able to review and re-evaluate the treatments (we talk about chronotherapy).
Thank you to Professor Claire Mounier-Vehier, cardiologist at the University Hospital of Lille and President of the French Federation of Cardiology.
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