CHS Blood Pressure Measurement Techniques & Monitoring 2 — Questions and Answers
Question 1: What is the standard duration for ambulatory blood pressure monitoring (ABPM)?
- 12 hours
- 18 hours
- 24 hours (Correct answer)
- 48 hours
Correct answer: 24 hours
Standard ABPM is performed over 24 hours to capture blood pressure variations across both daytime activity and nighttime sleep.
Question 2: What is the normal 'dipping' pattern identified on ambulatory blood pressure monitoring?
- Less than 5% nighttime reduction
- 10–20% reduction in nighttime BP compared to daytime (Correct answer)
- Greater than 20% nighttime reduction
- No change between daytime and nighttime BP
Correct answer: 10–20% reduction in nighttime BP compared to daytime
Normal dippers show a 10–20% reduction in nighttime blood pressure; non-dipping is associated with increased cardiovascular and renal risk.
Question 3: According to ABPM criteria, what 24-hour average blood pressure threshold defines hypertension?
- ≥130/80 mmHg
- ≥135/85 mmHg (Correct answer)
- ≥140/90 mmHg
- ≥125/75 mmHg
Correct answer: ≥135/85 mmHg
The 24-hour ABPM hypertension threshold is ≥135/85 mmHg, which is lower than the office measurement threshold of 140/90 mmHg.
Question 4: Which condition is defined as consistently elevated office blood pressure with normal readings confirmed by ABPM or home monitoring?
- Masked hypertension
- White coat hypertension (Correct answer)
- Sustained hypertension
- Labile hypertension
Correct answer: White coat hypertension
White coat hypertension is characterized by office BP ≥140/90 mmHg with normal out-of-office BP (<130/80 mmHg on ABPM), likely due to an alerting response in the clinical setting.
Question 5: What is 'masked hypertension'?
- Hypertension that presents without any symptoms
- Normal office BP with elevated readings on ABPM or home monitoring (Correct answer)
- Hypertension that resolves with antihypertensive treatment
- Blood pressure elevation occurring only in the morning
Correct answer: Normal office BP with elevated readings on ABPM or home monitoring
Masked hypertension is characterized by normal office BP with elevated out-of-office measurements and carries similar cardiovascular risk to sustained hypertension.
Question 6: How frequently should patients measure blood pressure when performing home blood pressure monitoring (HBPM) according to current guidelines?
- Once per week
- Once daily in the morning only
- Twice daily (morning and evening) for at least 7 days (Correct answer)
- Three times daily for 3 days
Correct answer: Twice daily (morning and evening) for at least 7 days
Guidelines recommend twice-daily readings for ≥7 days (with the first day often discarded) to obtain a reliable home BP average that reflects true out-of-office pressure.
Question 7: Which is a unique clinical advantage of ABPM over standard office blood pressure measurement?
- Lower patient cost
- Easier for patients to perform
- Ability to detect nocturnal hypertension and non-dipping patterns (Correct answer)
- Eliminates the need for patient cooperation
Correct answer: Ability to detect nocturnal hypertension and non-dipping patterns
ABPM is the only method that captures nighttime blood pressure, enabling identification of nocturnal hypertension and non-dipping, both of which increase cardiovascular risk independently.
CHS Blood Pressure Measurement Techniques & Monitoring 2
What is the standard duration for ambulatory blood pressure monitoring (ABPM)?