Antecedent rest may not be necessary for automated office blood pressure at lower treatment targets

Abstract

In SPRINT (Systolic Blood Pressure Intervention Trial), use of the Omron 907XL blood pressure (BP) monitor set at 5 minutes of antecedent rest to record BP produced an automated office BP value 7/6 mm Hg lower than awake ambulatory BP at 27 months.The authors studied the impact on automated office BP of setting the Omron 907XLto 0 minutes instead of 5 minutes of rest in patients with readings in the lower normal BP range, similar to on-treatment BP in the SPRINT intensive therapy group.Patients (n = 100) in cardiac rehabilitation were randomized to three BP readings at 1-minute intervals using an Omron 907XL BP device set for 5 or 0 minutes of antecedent rest. Mean (±standard deviation) automated office BP (mm Hg) after 5 minutes of rest (120.2 ± 14.6/66.9 ± 8.6 mm Hg) was lower (P < .001/P < .01) than without rest (124.2 ± 16.4/67.9 ± 9.1 mm Hg). When target BP is in the lower normal range, automated office BP recorded without antecedent rest using an Omron 907XL device should be higher and closer to the awake ambulatory BP, compared with readings taken after 5 minutes of rest.

Determination of optimal on‐treatment diastolic blood pressure range using automated measurements in subjects with cardiovascular disease—Analysis of a SPRINT trial subpopulation

“…The conclusions from our research are limited because of the different protocols used with the automated devices. For example, Colella et al reported a closer relationship between AOBPM and the mean awake ambulatory BP when the pre‐measure resting period was shortened from 5 to 0 minutes. It should also be stressed that probably only ~50% of measurements were truly unattended in the SPRINT trial .…”

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

“…The AOBP values were found to be lower than awake ABP in both groups suggesting that office BP values in the lower range of normal were lower than the awake ABP. Taking these findings into account, Colella et al compared AOBP using the Omron HEM 907 monitor, with and without preceding rest, and concluded that in the lower normal range AOBP recorded without preceding rest should be higher and closer to the awake ABP although 24‐hours ABP was not performed. Consequently, we conducted this study to clarify whether AOBP readings, in treated and untreated hypertensives, can be used without a rest period using also awake ABP monitoring as a comparator.…”

Response to the Letter to the Editor on “Antecedent rest may not be necessary for automated office blood pressure at lower treatment targets”

“…2 Using this technique in SPRINT, office BP at target (120/66 mm Hg) was 7/6 mmHg lower than the corresponding awake ambulatory BP. 3 The results of our study 4 suggested that the Omron 907 without any antecedent rest should produce readings which more closely approximate the awake ambulatory BP, when systolic BP is in the target range of 120-130 mmHg. Dr Padwal 5 seems concerned about the variability of automated office (AO) BP.…”