Guidelines recommend 1 to 2 minutes between repeated, automated office-based blood pressure (AOBP) measures, which is a barrier to broader adoption. Patients from a single hypertension center underwent a 3-day evaluation that included a 24-hour ambulatory blood pressure (BP) monitor (ABPM) and one of two nonrandomized, unattended AOBP protocols. Half of the patients underwent 3 AOBP measurements separated by 30 seconds, and the other half underwent 3 BP measurements separated by 60 seconds. All measurements were compared with the average awake-time BP from ABPM and the first AOBP measurement. We used linear regression to assess whether the 30-second protocol was associated with individual or average AOBP measurements or awake-time ABPM and used an interaction term to determine whether interval modified the relationship between AOBP measurements (individual and mean) with awake-time ABPM. Among 102 patients (mean age, 59.2±16.2 years; 64% women; 24% Black), the average awake-time BP was 132.5±15.6/77.7±12.2 mm Hg among those who underwent the 60-second protocol and 128.6±13.6/76.5±12.5 mm Hg for the 30-second protocol. Mean systolic/diastolic BP was lower with the second and third AOBP measurement by −0.5/−1.7 mm Hg and −1.0/−2.3 mm Hg for the 60-second protocol versus −0.8/−2.0 mm Hg and −0.7/−2.7 mm Hg for the 30-second protocol; protocol did not significantly modify these differences. Differences between AOBP measurements (first, second, or third) and awake-time ABPM were nearly identical across protocols. In conclusion, a 30-second interval between AOBP measurements was as accurate and reliable as a 60-second interval. These findings support shorter time intervals between BP measurements, which would make AOBP more feasible in clinical practice.
Automated office blood pressure measurements obtained with and without preceding rest are associated with awake ambulatory blood pressure
