Holter blood pressure

What is a blood pressure Holter?

The blood pressure Holter is a diagnostic test performed in Cardiology to measure blood pressure in a subject over an extended period of time, usually 24 hours. The objective is to monitor the patient’s blood pressure and to locate at what times or with what activities the patient has sudden changes in blood pressure.

There are two types of Holter tests, the one that measures blood pressure and the one that measures heart rate. This test gets its name from the biophysicist Norman Golter, who in 1949 established the theoretical foundations of cardiac monitoring.

What does it consist of?

The Holter blood pressure monitor consists of applying a cuff with a measuring device to collect blood pressure levels throughout the day, even during sleep if necessary.

The cuff is placed on the patient’s non-dominant arm, and will be connected by wires to a small device, similar in shape and size to a boom box, which can be clipped to a belt or carried in a pocket. This device can be concealed neatly under clothing and the patient should wear it at all times and carry out normal activities while wearing it. The device reads the pressure every 15 to 20 minutes during periods of activity and every 30 minutes during sleep.

When the test is finished, the device is removed and the recorded frequencies are read by a computer. The cardiologist specialist usually draws a graph from these frequencies for observation.

Why is it performed?

The purpose of the Holter blood pressure monitor is to follow the subject’s blood pressure throughout his or her normal day:

  • It is usually performed in patients who are suspected of having hypertension but it has not been confirmed at the time of consultation or to monitor hypertensive patients who are difficult to control or who are taking medication that may influence blood pressure.
  • It is also performed to assess the effectiveness of the patient’s blood pressure treatment.
  • In those patients who present episodic hypertension, or a highly variable blood pressure, this follow-up is also performed to see when or what activities are detrimental to their blood pressure.
  • Not only in cases of hypertension, patients with arterial hypotension may also need Holter monitoring.
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Preparation for Holter blood pressure monitoring

The patient usually does not need to prepare for this test, as the goal is to record their normal day’s activity. Therefore, he/she should perform the same activities that normally occupy him/her, take his/her usual medication and avoid strenuous physical exercise or activities that cause unusual nervousness and stress.

The cardiologist may also ask the patient to write down the medications he/she is taking or the activities he/she has been doing on the day of the test.

How do you feel during the test?

The Holter blood pressure monitor is a completely painless test, during which the patient will feel only the usual discomfort of wearing the monitoring device with the cuff on the arm all day and all night.

Meaning of abnormal results

When abnormal results are obtained on the Holter blood pressure monitor, it means that the patient’s blood pressure is irregular or moving at abnormally high (hypertension) or abnormally low (hypotension) levels. In any case, the cardiologist specialist should analyze these results, find the cause and establish a treatment to stabilize the patient’s pressure.