Automated office blood pressure measurements obtained with and without preceding rest are associated with awake ambulatory blood pressure

Automated office blood pressure (AOBP) measurement, attended or unattended, eliminates the white coat effect (WCE) showing a strong association with awake ambulatory blood pressure (ABP). This study examined the difference in AOBP readings, with and without 5 minutes of rest prior to three readings recorded at 1-min intervals. Cross-sectional data from 100 randomized selected hypertensives, 61 men and 39 women, with a mean age of 52.2 +/- 10.8 years, 82% treated, were analyzed. The mean systolic AOBP values without preceding rest were 127.0 +/- 18.2 mm Hg, and the mean systolic AOBP values with 5 minutes of preceding rest were 125.7 +/- 17.9 mm Hg (P = .05). A significant order effect was observed for the mean systolic BP values when AOBP without 5 minutes of preceding rest was performed as the first measurement (130.0 +/- 17.7 vs 126.5 +/- 16.2, P = .008). When we used a target systolic AOBP >= 130 mm Hg, awake ABP yielded lower readings, while at a target systolic AOBP value of < 130 mm Hg higher awake ABP values were obtained. Our findings indicate that systolic AOBP can be initially checked without any preceding rest and if readings are normal can be accepted. Otherwise, when AOBP is >= 130 mm Hg, measurements should be rechecked with 5 minutes of rest.