Subhead: How cardiologists are using cuffless ABPM to uncover hidden hypertension
When a patient tells her doctor she consistently feels unwell at a certain time of day, it isn’t an obvious case of hypertension if her office blood pressure is normal.
Because blood pressure is dynamic, many people with elevated numbers at night or early in the morning remain undiagnosed for hypertension. Roughly 41% of women and 51% of men with hypertension (around 580 million people worldwide) are unaware they have hypertension, according to a pooled analysis of 1201 population-representative studies with 104 million participants published in The Lancet.
Only with access to blood pressure readings over 24 hours does a woman with high blood pressure outside of a clinic visit get diagnosed and treated for a condition that’s known as the “silent killer.”
On this year’s World Heart Day, focusing on the theme of “Don’t Miss a Beat,” the World Heart Federation encourages physicians to recognize hidden or subtle symptoms of heart disease early. With cuffless 24-hour ambulatory blood pressure monitors (ABPM), cardiologists can do just that.
Hypertension is underdiagnosed and uncontrolled worldwide
While hypertension affects a third of the world’s adult population (33% of adults aged 30 to 79), according to the World Health Organization, far fewer people are diagnosed and treated before the condition leads to other cardiovascular diseases like a heart attack or stroke. In the U.S., 48% of the adult population has hypertension, and less than 1 in 4 of those with high blood pressure has their blood pressure under control (22.5%)
A 2023 observational study published in The Lancet followed 59,124 patients from the Spanish Ambulatory Blood Pressure Registry. The investigators found that 24-hour ambulatory systolic blood pressure was more informative than clinic systolic blood pressure for predicting all-cause and cardiovascular mortality. The study also demonstrated the prognostic importance of nighttime measurements.
The findings underscore how cardiovascular risk accumulates outside the exam room.
Simply put, a blood pressure measurement at 10 a.m. in the clinic or even at home can’t tell a physician with certainty what that patient’s blood pressure is doing while commuting, working, taking medication, eating dinner or sleeping.
Why hypertension remains a ‘silent killer’
Much of the reason hypertension persists among so many adults in the U.S. and around the world is a capacity problem. Despite recent evidence-based guidelines from the ACC/AHA recommending more widespread use, most patients who need hypertension screening don’t ever access an ABPM device. Fewer than 0.5% of commercially insured patients with newly treated hypertension or apparent treatment-resistant hypertension have ambulatory blood pressure monitors (ABPM) claims submitted to their insurance.
Traditional ABPM devices are limited in supply, operationally taxing for clinic staff, and burdensome for patients to wear for over 24 hours. Instead of using 24-hour ABPM, patients with slightly elevated blood pressure readings in the office are told to record their blood pressure at home or return for follow-up appointments. Neither option offers 24-hour screening, which captures key indicators of hypertension, such as nighttime blood pressure and morning spikes.
Cuffless ABPM scales hypertension screening
Disposable and cuffless 24-hour ABPM allows doctors to test anyone with symptoms or increased risk of hypertension. Instead of reserving the few traditional ABPM devices a clinic typically has for patients with more obvious signs of hypertension, any patient who has suspected hypertension or even just an increased genetic risk of heart disease can be screened.
With clinically validated cuffless ABPM, doctors can easily screen every patient with even the slightest indication of hypertension, including a patient who consistently feels unwell at a certain time of day.
The value of 24-hour ABPM in hypertension diagnosis and treatment is well known. Making it routinely accessible has been insurmountable until now.
This World Heart Day challenge to cardiologists to recognize what can otherwise remain hidden is an opportunity to commit to scaling ABPM screening with FDA-cleared cuffless ABPM.
Contact us to set up a demo and see how Biobeat’s FDA-cleared cuffless 24-hour blood pressure monitoring solution helps physicians improve diagnostic confidence and support better long-term cardiovascular and cognitive outcomes.