What Is An Ambulatory Blood Pressure Monitor (ABPM)?

A wearable 24-hour ABPM accurately reads blood pressure in real time

Ambulatory blood pressure monitoring (ABPM), first introduced in the 1960s, is now widely used to assess blood pressure in real time. ABPM allows a healthcare provider to assess your blood pressure during your routine activities in daily life, whether working, sleeping, or doing chores.

Because "ambulatory" refers to being in motion, the technique is preferred because the ambulatory blood pressure monitor is accurate when compared with "whitecoat" readings altered by being in a healthcare provider office.

This article explains what is meant by ambulatory blood pressure monitoring, how the ABPM devices work, and information about some models that you may want for home use.

Woman checking blood pressure in living room
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How It Works

Ambulatory blood pressure monitoring is accomplished with a special device that consists of a blood pressure cuff worn on your arm. It's attached to a small recording device that you wear on your belt.

You wear the ABPM device for 24 hours. Throughout that period, it records your blood pressure, typically at 15-minute or 30-minute intervals, during your routine daily activities and while you are sleeping. The ABPM provides your healthcare provider with a complete record of your blood pressure, which fluctuates (changes) throughout the day and night.

A blood pressure reading taken in a healthcare provider's office records a single value while you're at rest. The ABPM information tracks your blood pressure in real time.

The ABPM does not report merely a single value for systolic and diastolic blood pressure that supposedly represents your official “blood pressure.” Instead, it reports an entire range of (often) widely variable values throughout the course of a day or longer.

What Is the Difference Between HBPM and ABPM?

The home blood pressure monitor (HPBM) works like the ABPM, but is less expensive and more readily available. It has value, notably in helping people to stick to their high blood pressure treatment plan, but may require people to write down readings rather than recording. The ABPM is preferred for diagnosing high blood pressure by the United States Preventive Services Task Force (USPSTF).

How Do You Measure Ambulatory Blood Pressure?

Using the ABPM to diagnose hypertension (high blood pressure) requires a different approach to interpreting your blood pressure recordings.

The technique most commonly used for evaluating the results of ABPM is to average a person's systolic and diastolic blood pressures across the full 24-hour period. Separate averages are calculated for the hours that you are awake and asleep.

High Ambulatory Blood Pressure

Normal blood pressure of 120 mmHg over 80 mmHg does not really change with an ABPM, but it is based on averages. Hypertension, or high blood pressure, is generally diagnosed if average blood pressure exceeds one of the following values:

  • 24-Hour ABPM Average: systolic blood pressure above 125 mmHg, OR diastolic blood pressure above 75 mmHg.
  • ABPM Average for “Awake” Hours: systolic blood pressure above 130 mmHg, OR diastolic blood pressure above 80 mmHg.
  • ABPM Average for “Asleep” Hours: systolic blood pressure above 110 mmHg, OR diastolic blood pressure above 65 mmHg.

When Is ABPM Used?

While high blood pressure readings taken in a healthcare provider's office may truly indicate hypertension is present, sometimes that is just not the case. ABPM is helpful in assessing people with white coat hypertension.

Some people have wide fluctuations in blood pressure and ABPM can help with a difficult diagnosis. It's also useful to investigate whether existing anti-hypertensive medications are working, or why they're not effective.

ABPM can help in the diagnosis and treatment of some forms of dysautonomia, an autonomic nervous system disorder that can lead to intermittent and unpredictable episodes of very low blood pressure.

ABPM Costs and Availability

In most cases, an ambulatory blood pressure machine is provided through your healthcare provider or a specialized hypertension center. They are used as part of an ABPM exam. The devices cost between $2,000 and $2,500, even for a primary care practice to acquire.

Usually, you will use one under the healthcare provider's direction. That means the provider will give it to you, but the cost for this service is $200 to $250. Keep in mind that insurance companies may approve its use only for certain conditions. The reimbursement rates also will vary, so check your own provider for details.

In some cases, ambulatory blood pressure monitor rental may be available through a pharmacy or clinic near you. That's a less common use, though, for the product.

ABPM Certification

Any ABPM device you use should be validated by an accredited organization, such as the Association for the Advancement of Medical Instrumentation (AAMI) or ESH International Protocol (ESH-IP). Not all primary care providers are trained in their use, so don't hesitate to ask about training before your ABPM exam with a professional, either.

A Word From Verywell

Ambulatory blood pressure monitoring is a way of assessing a person’s blood pressure during their routine daily activities and during sleep. This measurement is often more accurate than those taken in a healthcare office. Ask your provider if you have questions about ABPM.

Frequently Asked Questions

  • How do you prepare for a 24-hour blood pressure monitor?

    You wear the ABPM device in daily life, so there's little preparation. You may not be able to shower or lift heavy items while wearing it, so consider doing so ahead of time or scheduling activities after it. You're not likely to have ABPM pain, but it may be difficult to sleep.

  • What is the best ambulatory blood pressure monitor?

    The answer will depend on your specific needs, and usually the ABPM is given to you by a healthcare provider for an ABPM exam. But if you need to rent or buy your own, and compare features, cost, and accuracy, you can research specific models on the dabl Educational Trust website.

  • What is normal blood pressure with an ABPM?

    Normal blood pressure of 120 mmHg over 80 mmHg is the same as it is when taken with a cuff, or with a home blood pressure monitoring (HBPM) machine. The difference is that the ABPM averages the pressure across a 24-hour period. It also averages active and sleeping-hour pressures separately.

8 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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  4. Bloomfield DA, Park A. Decoding white coat hypertension. World J Clin Cases. 2017;5(3):82-92. doi:10.12998/wjcc.v5.i3.82

  5. Goldberg L, Bar-aluma BE, Krauthammer A, Efrati O, Sharabi Y. Ambulatory blood pressure profiles in familial dysautonomia. Clin Auton Res. 2018;28(4):385-390. doi:10.1007/s10286-018-0507-1

  6. American Academy of Family Physicians. Five steps to set up ambulatory blood pressure monitoring in your practice.

  7. Krakoff LR. Ambulatory blood pressure improves prediction of cardiovascular risk: implications for better antihypertensive management. Curr Atheroscler Rep. 2013;15(4):317. doi:10.1007/s11883-013-0317-9

  8. American Heart Association. Monitoring your blood pressure at home.

Additional Reading

By Richard N. Fogoros, MD
Richard N. Fogoros, MD, is a retired professor of medicine and board-certified in internal medicine, clinical cardiology, and clinical electrophysiology.