ABPM · Sibiu

24 hour blood pressure monitoring in Sibiu

A single reading at the clinic says very little. ABPM records your blood pressure at regular intervals, day and night, and shows the real pattern, including what happens while you sleep.

Book an appointment 0771 193 295

What 24 hour automatic blood pressure monitoring is

Blood pressure is not a fixed number. It climbs with exertion and with emotion, it drops while you sleep, and it reacts to coffee, to a bad night or to a tense conversation. One reading at the clinic is a single photograph taken from a twenty four hour film.

Ambulatory blood pressure monitoring, also known as ABPM or a “blood pressure Holter”, films the whole thing. You wear a cuff on your arm, connected to a small device clipped to your belt, and it inflates by itself at regular intervals, day and night, without you having to do anything.

At the end, the data is downloaded and you get something no single reading can give you: the 24 hour average, the average across your active hours, the average during sleep, and how much the values swing over the course of the day.

This method gives a clear picture of how your blood pressure fluctuates during the day and during the night. It is essential for a correct diagnosis of hypertension and for adjusting antihypertensive treatment, which is to say for exactly the two decisions where a mistake costs the most.

The device records, it does not decide. The interpretation happens in context: what symptoms you have, what treatment you are taking and what the rest of the assessment shows. A sheet of numbers, read on its own, is not a diagnosis.

When 24 hour monitoring makes sense

Sometimes your doctor asks for it, sometimes it starts from a mismatch you spotted yourself between the machine at home and the one at the clinic. Monitoring is worth doing if you recognise yourself below.

Your blood pressure comes out high at the clinic, but at home the readings look normal
You get high readings at home, but at the doctor everything seems fine
You have been told your blood pressure is borderline and it is not clear whether you need treatment
You are about to start antihypertensive treatment and you want the decision to come from data, not from two readings
You are already on treatment and you do not know whether the dose is enough or, on the contrary, too high
You have felt dizzy or tired since you started or changed your medication
Your readings vary a lot from one measurement to the next and you cannot tell which one is the real one
You wake up with headaches, you snore loudly, or you have been told that you pause your breathing in your sleep
You have diabetes, chronic kidney disease or metabolic syndrome, situations where your blood pressure profile during sleep matters a great deal
You were diagnosed with hypertension at a young age and you want solid confirmation before starting long term treatment

If right now you have very high readings together with chest pain, serious difficulty breathing, disturbed vision or weakness down one side of your body, do not wait for an appointment. Call 112.

How the monitoring goes

The device is fitted at the clinic, you wear it for a full day while keeping to your usual routine, then you bring it back so the data can be downloaded.

Getting ready
You need no medical preparation at all. Wear a loose top or shirt with a sleeve wide enough to go over the cuff, because the cuff stays directly on your arm the whole time.
Fitting the device
We take a reference reading, choose the right cuff size and fit the device. You get an explanation of what to do when the cuff inflates and how to fill in the diary.
The 24 hours
Live your day as normal. That is exactly the point: your blood pressure in your real life, not from a day spent sitting in a chair. Note down your sleeping hours, any exertion, the medication you took and any symptoms.
Handing the device back
The next day you bring the device back, the recording is downloaded and a report is generated with all the readings, the averages for each period and the graph of how your pressure moved through the day and the night.
Interpretation and the decision
The result is read through together with you, alongside your symptoms and your current treatment. The decision starts from there: treatment is started, an existing one is adjusted, or we simply set the rhythm for follow up.

How to read blood pressure numbers

Blood pressure is written as two numbers. The first is the systolic pressure, the pressure in your arteries at the moment your heart contracts. The second is the diastolic pressure, the pressure left between two beats, while the heart relaxes and fills. Both matter, and one of them being raised on its own is enough to put a question mark there.

The thresholds the guidelines work from differ depending on where the measurement is taken, and that surprises a lot of people. At the clinic, hypertension is discussed from 140 over 90 mmHg upwards. At home, with a validated device, the threshold sits around 135 over 85. For 24 hour monitoring, the guidelines use a whole day average from 130 over 80 upwards, an average across the active period from 135 over 85, and an average during sleep from 120 over 70.

The reason the thresholds are lower for monitoring is simple: a 24 hour recording holds a great many readings, taken in ordinary conditions, without the tension of the clinic. The resulting average sits closer to reality, so the point at which concern begins comes down.

These figures are guideline reference points, not verdicts. They say where the conversation starts, not what you have. Where you actually fall depends on your age, on other conditions, on your treatment, on your overall cardiovascular risk and on your symptoms. Two people with the same average can be given different recommendations, and that is settled at the consultation.

Two things that come up often. In adults, the diagnostic thresholds do not relax with age, even though treatment targets can be gentler in older or frail people. The idea that “at 70 it is normal to run 170” does not hold up. And your pulse is a different parameter, read separately: a fast pulse does not automatically mean high blood pressure.

As for exertion, it is normal for systolic pressure to rise when you climb stairs or lift something heavy, and then to come back down. A proper reading is taken sitting down, with your back supported, after five minutes of quiet, with your arm supported at heart level, not straight after exertion or after coffee.

Why one reading at the clinic can mislead you

There is a well described phenomenon called white coat hypertension. Your blood pressure climbs in the consulting room for the simple reason that you are there, and it returns to normal for the rest of your life. If the decision is made on those readings alone, you can end up on treatment you do not need, with dizziness and tiredness as the price.

There is a mirror image of it, more dangerous, called masked hypertension. At the clinic the numbers look lovely, and through the rest of the day, at work, in traffic or at night, the pressure is high. Here the risk is not one treatment too many, it is years in which real hypertension goes undiagnosed.

A related situation shows up in people already on treatment: the clinic readings stay high despite the medication, but monitoring shows that in real life the pressure is in fact controlled. Without that check, medicines can be added for nothing.

24 hour monitoring separates these situations from one another, because it does not depend on a single day and a single room.

What happens to your blood pressure in your sleep, and why it matters

Normally, blood pressure falls during sleep compared with the active part of the day. That fall is natural, the nocturnal dipping profile, the sign that the nervous system has moved into rest mode. Night time readings are the only way to see whether that happens in your case, because nobody wakes up hour after hour to measure themselves.

When the dip during sleep is missing, or when pressure climbs at night instead of falling, the picture changes. It is a pattern that deserves attention, and the causes are looked for further out: sleep apnoea, kidney disease, diabetes, treatment taken at the wrong time of day, or poor quality sleep.

The link with sleep apnoea is the one we most often see missed. Loud snoring, pauses in breathing noticed by your partner, sleep that does not rest you, a morning headache and blood pressure that is hard to control often travel together. If the night recording raises that suspicion, a dedicated investigation follows.

Prices

Prices
Service	Price
Cardiology consultation + ECG	400 lei
Cardiology consultation + ECG + echocardiography	620 lei
Cardiology follow-up + ECG	300 lei
Echocardiographyincludes an orientative assessment of the liver, the carotid arteries and the thyroid	400 lei
Holter ECG monitoring24 hours	370 lei
Ambulatory blood pressure monitoring (ABPM)24 hours	370 lei
Exercise stress test on a cycle ergometer	450 lei
Body composition analysis	100 lei
Ankle-brachial index (ABI)with interpretation	100 lei
Electrocardiogram (ECG)	100 lei
ECG + SDS (sudden death screening)extended BTL assessment, for people up to the age of 35	150 lei
Intravenous Ferinject 500 mgmedication and medical supervision included	800 lei
Intravenous vitamin C (Pascorbin 7.5 g)product and medical supervision included	350 lei

You have seen the prices. Shall we go ahead?

Tell us what brings you to a cardiologist and we will suggest a time that works for you.

Book an appointment 0771 193 295

Frequently asked questions

Does 24 hour blood pressure monitoring hurt?

It does not hurt. The cuff inflates and squeezes your arm for a few seconds, exactly as in an ordinary reading, then it deflates. Most people get used to it after the first few inflations. If it becomes genuinely unpleasant, tell us, we can change the cuff size or the arm you wear it on.

Can I sleep with the device on?

Yes, and it is important that you do, because the readings taken during sleep are among the most valuable in the whole recording. The device measures less often at night, so it disturbs you as little as possible. It is normal to wake up for a few of the readings, and if you had a completely atypical night, write it in the diary.

Can I shower or have a bath?

No. The device and the cuff must not come into contact with water, so while the monitoring is running there is no shower and no swimming pool. Have your shower before you come in to have it fitted.

Can I go to work and do sport?

Yes, go to work and live your usual day, because that is exactly what we want to see. Intense physical exertion and heavy sweating are best avoided, because they can shift the cuff and give faulty readings. Walking and desk work are not a problem.

What do I do when the cuff starts to inflate?

Let your arm hang relaxed, straight and still, and do not talk until the reading finishes. Sit down if you can. Moving your arm is the main cause of wrong values and of the device repeating the measurement.

Why is a full 24 hours needed, and readings at night?

Because blood pressure follows a daily pattern, and half the information leads to the wrong decisions. Without the sleep period there is no way to see whether your pressure comes down normally at night, and that is one of the things that most often changes where you fall and the time of day the medication is recommended for.

Do I take my usual medication on the day of the monitoring?

As a rule, yes, because very often the point is precisely to see how well the treatment you are taking is working. Do not stop or change anything on your own initiative. If your case calls for something different, you will be told before the device is fitted, and the times you took your tablets go into the diary.

Are a “blood pressure Holter” and ABPM the same thing?

Yes, they are two names for the same investigation. In everyday speech people say blood pressure Holter, in medical documents it appears as ABPM or ambulatory blood pressure monitoring. Do not confuse it with a Holter ECG, which records the electrical activity of the heart and is done for palpitations and rhythm disorders.

Do I need a referral letter or any paperwork?

Ask us on the phone when you book and we will tell you exactly what you need in your case, so you do not make the trip for nothing.

When do I find out the result and what do I get at the end?

The data is downloaded the moment you bring the device back, and the report contains all the readings, the averages over 24 hours, over the active period and over sleep, plus the graph of how it changed. What matters is what comes next: the interpretation in your context and the decision about treatment.