December 2025
Accuracy of waiting room automated office blood pressure measurements assessed
By Rebecca Jenkins
Automated office blood pressure measurement (AOBPM) taken in a waiting area is similarly accurate for diagnosing hypertension as measurements taken in an isolated room, a study finds.
Unattended AOBPM typically involved a patient having several automatic blood pressure (BP) readings taken while sitting in a quiet examination room, without a doctor or other staff present, after five minutes of rest.
Several international guidelines endorsed the practice, which aimed to negate most of the ‘white coat effect’.
However, writing in the Journal of the American Heart Association, the researchers said its real-world uptake had been limited, largely because it was difficult to secure an isolated room to take measurements.
To test whether accurate results could instead be attained in a waiting room, researchers designed a cross-sectional study comparing the performance of standard office BP measurement, AOBPM taken unattended in an isolated room and AOBPM taken in a waiting room.
Out of 548 participants included in the final analysis of the study, 349 (64%) had a history of hypertension, while 199 (36%) were being studied for a diagnosis of hypertension.
Data were collected during two patient visits to participating clinics at 14 Spanish and Portuguese hospitals, and the three methods were then compared against gold-standard measurements from daytime ambulatory BP monitoring.
Compared with daytime ambulatory BP monitoring, researchers found waiting room AOBPM had equivalent accuracy for diagnosing hypertension to unattended AOBPM in an isolated room (73% accuracy vs 75% accuracy). In addition, both methods were superior to standard office BP measurement (62% accuracy).
The study comes after the recent release of a Hypertension Australia and the National Hypertension Taskforce of Australia consensus statement endorsing AOBPM as the standard for diagnosing and managing hypertension.
The statement said AOBPM was ideally performed in a dedicated quiet room, but noted the practice waiting room was a suitable alternative.
Professor Markus Schlaich, Chair in Clinical Research at the Dobney Hypertension Centre, Royal Perth Hospital and President of Hypertension Australia, welcomed the latest study and said there was great interest in the most appropriate setting for AOBPM.
‘Often GPs have concerns that they do not have the space to allow for unattended AOBPM in an isolated quiet room,’ he told Medicine Today.
In this latest study, Professor Schlaich said it was important to note that different thresholds for the definition of hypertension were used with each method, and that the absolute numbers differed more markedly with waiting room measurement.
For instance, there was no discrepancy in systolic BP between the unattended AOBPM and the daytime ambulatory measurements, which was not the case for waiting room AOBPM.
‘This paper is useful to highlight that while not as accurate as unattended AOBPM in an isolated room, measurement in the waiting room is helpful, if it’s conducted in a standardised fashion,’ Professor Schlaich said.
Ideally, nationwide implementation of unattended AOBPM in an isolated room was the best way forward for Australia to standardise BP measurements and give practitioners increased confidence to act on recorded levels, Professor Schlaich said.
‘This will improve BP control rates, which remain very low in Australia,’ he said, noting that currently only 32% of people with hypertension in Australia had their BP treated and controlled to less than 140/90 mmHg.