Dear Editor,
Stults et al1 highlight a major problem with how office blood pressure (BP) is often recorded in clinical practice, that is, a single measurement with little or no antecedent rest. Otherwise, a conventional office BP recorded in duplicate after 5 minutes of rest according to the guidelines requires about 8 minutes, which is similar to the time required to obtain an automated office (AO) BP reading.
These authors suggest that the Omron 907 can be used to screen for hypertension without any antecedent rest. However, there are no data with mean office BP in the hypertensive range showing that the awake ambulatory BP is similar to an AOBP recorded using the Omron 907 set for three readings at 1‐minute intervals and no period of rest. Therefore, it would be premature to use this method for hypertension screening, even if it does require less time to obtain a reading.
As in the Systolic Blood Pressure Intervention Trial,2 AOBP recorded with the Omron 907 set for three readings at 1‐minute intervals after 5 minutes of rest takes approximately 8 minutes. The BpTRU also requires 8 minutes to record five readings, if the time needed for the initial test reading is included. The WatchBP Office records three readings at 1‐minute intervals after a 1‐minute delay, which allows time for the doctor or nurse to leave the patient alone. Thus, AOBP readings do not require any more time than readings recorded by office staff. Moreover, the patient can be left alone before and during the AOBP measurements, whereas the doctor or nurse must be present if they record the BP themselves.
These three AOBP recorders also differ in the timing of the measurements. The BpTRU readings are timed 1 minute from the start of one reading to the start of the next one, whereas readings recorded with the Omron 907 and WatchBP Office are timed 1 minute from the end of a reading until the start of the next one. Thus, five readings with the BpTRU take about the same time as three readings with the other devices.
There should not be any concern about the time required to record AOBP when screening for hypertension, since it is no different than the time needed for a doctor or nurse to perform a proper manual or electronic office BP measurement. However, when office BP is in the normal range, with systolic readings <130 mm Hg, it may be possible to use the Omron 907 with the 0‐minute rest setting; otherwise, adding 5 minutes of rest could result in readings which are much lower than the corresponding awake ambulatory BP.3
CONFLICT OF INTEREST
No conflict of interest.
REFERENCES
- 1. Stults B, Doane J, Penrod J, Conroy M. Does automated office blood pressure require a 5‐minute rest period when used to screen for hypertension? J Clin Hypertens. 2018. 10.1111/jch.13446. [Epub ahead of print] [DOI] [PMC free article] [PubMed] [Google Scholar]
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