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: Facilities : ABP
Ambulatory blood pressure monitoring (ABPM) takes numerous readings of your blood pressure over a 24-hour period or longer. It provides accurate and reliable information and can give you and your doctor a truer picture of your blood pressure than occasional visits and readings taken at your doctor's office.
How often will my blood pressure be taken?
Usually, your heart rate and blood pressure will be measured at 15 to 30 minute periods during the day and every 30 minutes to one hour at night. Although you may notice the first few times the cuff inflates, you will soon become used to the monitor. Most people find them very easy to wear.
How does APBM work?
Most ambulatory blood pressure monitors use either what's called an ausculatory method or an oscillomtetric method. Blood pressure sounds are determined by the ausculatory method that uses microphones under the blood pressure cuff. The oscillometric method involves measuring movement of the blood after closing off the brachial artery, the main artery that runs from the shoulder down to the elbow.
ABPM is now a routine procedure in Europe and it is being used increasingly in the United States to evaluate hypertension and related conditions such as:
- White Coat Hypertension - This means that you only have high blood pressure when you are in the doctor's office. Studies suggest that more than 20 percent of patients identified as having high blood pressure are misdiagnosed because they have "White Coat" hypertension. ABPM takes away the guesswork and gives a more realistic picture of blood pressure. It can help doctors solve the diagnostic problem that "White Coat hypertension" presents.
- White Coat Normotension - About five percent of the population has "White Coat" normotension. This means that your blood pressure is lower when it's being taken in the doctor's office, but rises when you leave. Ambulatory Blood Pressure Monitoring can alert your doctor to the true state of your blood pressure if you have "White Coat" normotension.
- Resistant Hypertension - This is diagnosed when several medications fail to control high blood pressure as measured in the doctor's clinic or office. The office reading may not be representative of your blood pressure over the course of a day. It depends, in part, on the time your blood pressure is measured in relation to the time your medications are taken. ABPM will show the degree and duration of medication action in your body. This will give your doctor valuable information to target your medications especially for you.
- Borderline Hypertension - Sometimes people have high normal blood pressure readings (a diastolic or bottom number of 85 to 89 mm) in the doctor's office. But, a closer look reveals that there is damage to the heart, kidneys or eyes because of the high blood pressure. ABPM can show higher readings outside of the doctor's office in association with physical activity, for example, or work-related stress. This may mean that casual measurements of your blood pressure in your doctor's office have underestimated the degree of hypertension.
- Episodic Hypertension - ABPM can help detect periodic high blood pressure that indicates another medical problem. ABPM can also help detect high blood pressure associated with some anxiety syndromes.
- Hypertension during Pregnancy - If you have chronic hypertension and become pregnant, your doctor may want to gather more comprehensive information about your blood pressure and may prescribe ABPM. If you're showing signs of toxemia, a kind of high blood pressure that appears after the 20th week of pregnancy in some people, ABPM may be appropriate.
Who should have ABPM?
Please consult with your doctor regarding whether or not ABPM is appropriate for you. It is often recommended for:
- Individuals whose home BP is significantly lower than their clinic or office BP (> 10-15 mmHg difference)
- Individuals whose BP is difficult to control on multiple blood pressure lowering drugs
- Individuals who have symptoms suggesting low BP on antihypertensive therapy
- Patients who have a history of heart disease and develop symptoms suggesting high BP during those symptoms
(e.g., heart failure, headaches, dizziness, etc).