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Does automated office blood pressure require a 5‐minute rest period when used to screen for hypertension?

Dear Editor, Automated office blood pressure (BP) sequential measurements performed on patients alone in the examination room (AOBP) re‐ duce white‐coat BP elevation and the need for out‐of‐office BP mea‐ surement.1 In patients whose systolic AOBP levels are >130 mm Hg, AOBP is within a few mm Hg of mean awake ambulatory BP.2 Hypertension guidelines support3,4 AOBP to screen for hyperten‐ sion. In their recent JCH publication,6 Colella et al conclude: “When screening for possible hypertension, the Omron 907XL should be used with 5 minutes of rest before three readings are recorded at 1‐minute intervals.” A 5‐minute rest period before AOBP measure‐ ments to screen for hypertension may not be necessary. AOBP stud‐ ies performed with no rest period using the BpTRU device (which takes six BP measurements at 1‐minute intervals, averaging the last five, but is no longer available) correlated within a few mm Hg of mean awake ambulatory BP in patients with mean systolic AOBP lev‐ els of 141,7 138,8 and 137 mm Hg.9 AOBP devices that average three AOBP measurements correlated closely with the BpTRU device (Omron HEM 907)10 and to mean awake ambulatory BP (WatchBP Office)11 without a rest period. Another AOBP study without a rest period found excellent concordance with mean awake ambulatory BP by averaging the second and third AOBP measurements at 2 and 4 minutes.12 The Hypertension Canada guideline notes that AOBP may be performed with “no special period of rest.”3 A 5‐minute rest period before AOBP measurements to screen for hypertension may inhibit AOBP utilization in real‐world clinical practice.