Key result
Thirty-minute AOBP overestimates systolic BP by ~7 mmHg compared with 24-hour ABPM.
Why the study?
Ambulatory blood pressure monitoring (ABPM) is limited in routine practice by cost, availability, and patient burden. Automated office blood pressure (AOBP) is a proposed practical alternative, but the agreement and diagnostic performance of 30-minute AOBP relative to 24-hour ABPM remained uncertain.
Does 30-minute automated office blood pressure monitoring provide comparable blood pressure agreement and diagnostic accuracy to 24-hour ambulatory blood pressure monitoring in adults evaluated for hypertension?
Cohort (n=79)
No
Does 30-minute automated office blood pressure monitoring provide comparable blood pressure agreement and diagnostic accuracy to 24-hour ambulatory blood pressure monitoring in adults evaluated for hypertension?
Answers are grounded in this paper and cite their sources.
Thirty-minute AOBP has high sensitivity and good discrimination as an initial screening tool for ambulatory hypertension, but systematic overestimation of BP and inability to capture nocturnal BP mean 24-hour ABPM remains required for confirmation.
Background Ambulatory blood pressure monitoring (ABPM) is the reference standard for diagnosing hypertension (HTN), but its use in routine practice remains limited because of cost, availability, and patient burden. Automated office blood pressure (AOBP) has been proposed as a practical alternative, although its performance relative to ABPM remains uncertain. Objectives To evaluate the agreement and diagnostic performance of 30-minute AOBP compared with 24-hour ABPM and to identify optimal cut-off values for detecting ambulatory hypertension. Methods In this prospective cohort study, 79 adults undergoing ABPM also underwent 30-minute AOBP measurement with automated readings every 5 minutes. The mean of the final six measurements was analyzed. Agreement was assessed using paired comparisons and Bland–Altman analysis. Diagnostic performance using receiver operating characteristic (ROC) analysis and agreement statistics. Results Thirty-minute AOBP values were consistently higher than ABPM measurements. Mean differences were +6.59/ + 7.27 mmHg for systolic/diastolic BP versus 24-hour ABPM and +3.73/ + 5.16 mmHg versus daytime ABPM (all p < 0.001). Bland–Altman analysis showed acceptable group-level agreement but wide limits of agreement. Sensitivity ranged from 84% to 96% and specificity from 28% to 79%. ROC analysis demonstrated good discrimination (AUC 0.77–0.87). The highest agreement with overall ABPM occurred at a cut-off of ≥140/84 mmHg (κ = 0.624). Conclusions Thirty-minute AOBP showed good discrimination for elevated ambulatory blood pressure but systematically overestimated BP relative to ABPM. It may serve as a practical screening tool, although normal AOBP values cannot reliably exclude ambulatory HTN and confirmation with 24-hour ABPM remains necessary. Central Illustration Diagnostic Performance of 30-Minute Automated Office Blood Pressure Compared With 24-Hour Ambulatory Monitoring
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Bui et al. (2026) conducted a cohort in Suspected hypertension undergoing 24-hour ambulatory blood pressure monitoring (n=79). 30-minute automated office blood pressure (AOBP) monitoring vs. 24-hour ambulatory blood pressure monitoring (ABPM) was evaluated on Mean systolic blood pressure difference (30-minute AOBP vs 24-hour ABPM) (MD +6.59 mmHg, p=<0.001). Thirty-minute AOBP systematically overestimated systolic/diastolic blood pressure by +6.59/+7.27 mmHg compared with 24-hour ABPM (p<0.001), achieving highest overall agreement at ≥140/84 mmHg (κ=0.624).
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