Cardiovascular

Compare 30-minute automated office blood pressure vs 24-hour ambulatory blood pressure monitoring: A prospective study.

Bui A, Nguyen Q, et al. • PloS one • 2026

PubMed 42970541 DOI 10.1371/journal.pone.0360957

TL;DR

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.

Key Findings

Results

Thirty-minute AOBP readings were systematically higher than 24-hour and daytime ABPM readings.

Mean differences versus 24-hour ABPM were +6.59 mmHg systolic and +7.27 mmHg diastolic.
Mean differences versus daytime ABPM were +3.73 mmHg systolic and +5.16 mmHg diastolic.
All differences had p < 0.001.
The study enrolled 79 adults undergoing ABPM, with AOBP automated readings every 5 minutes over 30 minutes and the mean of the final six measurements analyzed.

Results

Bland-Altman analysis showed acceptable group-level agreement between AOBP and ABPM but wide limits of agreement.

Agreement was assessed using paired comparisons and Bland-Altman analysis.
Wide limits of agreement indicate substantial individual-level variability between the methods.

Results

Thirty-minute AOBP had high sensitivity but variable, often low, specificity for detecting ambulatory hypertension.

Sensitivity ranged from 84% to 96%.
Specificity ranged from 28% to 79%.
Normal AOBP values cannot reliably exclude ambulatory hypertension.

Results

ROC analysis showed good discrimination of AOBP for elevated ambulatory BP.

AUC ranged from 0.77 to 0.87.

Results

The AOBP cut-off with the highest agreement with overall ABPM was ≥140/84 mmHg.

Cohen's kappa at this cut-off was κ = 0.624.
Cut-off values were identified through ROC analysis and agreement statistics.

Conclusions

The authors conclude that 30-minute AOBP may serve as a screening tool but does not replace 24-hour ABPM for confirmation.

AOBP systematically overestimated BP relative to ABPM.
Confirmation with 24-hour ABPM remains necessary.

What This Means

This study compared a 30-minute automated office blood pressure test, in which a machine takes a reading every 5 minutes without staff in the room, to the standard 24-hour ambulatory monitor worn during daily life. The 79 adults in the study had both tests. The office readings were consistently higher than the 24-hour readings, by about 6-7 mmHg on average, and by somewhat less compared with daytime readings. The office test was good at picking up people with high ambulatory blood pressure, with sensitivity of 84-96%. It was less good at correctly identifying people without hypertension, with specificity of 28-79%. Agreement was best at a threshold of 140/84 mmHg. Individual differences between the two methods were large. This research suggests the 30-minute office test could be a practical screening option where 24-hour monitoring is costly or hard to get. However, a normal office result cannot reliably rule out hypertension, and the 24-hour monitor is still needed to confirm. The study was small, at 79 people, so the findings should be confirmed in larger groups.

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Citation

Bui A, Nguyen Q, Bui A, Ha M, Nguyen N, Nguyen T, et al.. (2026). Compare 30-minute automated office blood pressure vs 24-hour ambulatory blood pressure monitoring: A prospective study.. PloS one. https://doi.org/10.1371/journal.pone.0360957

Key Findings

What This Means

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