We need at least one extra separate room with a person in charge to manage the AOBP measurement and the cost of the measurement is generally not reimbursed.
Furthermore, the consumption of office space in addition to long measurement time reduces the feasibility of AOBP. Although the antecedent rest time might not be mandatory when systolic blood pressure level is <130 mmHg, the amendment of the measurement protocol according to the estimated values makes it difficult to evaluate and compare the measurements among individuals. Whereas, a conventional office blood pressure measurement also requires more than a few minutesʼ antecedent rest when faithfully based on recent guidelines. The discard of the first reading serves as the antecedent rest time, and it is fair to prepare a certain rest time before the first measurement-5 min would be acceptable regarding conventional measurement-when we average all the measurement values. However, as we discussed in detail elsewhere, this statement can be applied almost exclusively for measurement using BpTRU (BpTRU Medical Devices, Coquitlam, Canada the company ceased operations in 2017) which usually performs six consecutive readings and averages two to six readings. The Hypertension Canada 2018 Guidelines stated that AOBP may be performed with no special period of rest.
raised concern about inhabitation of AOBP utilization in real-world settings the AOBP including antecedent rest time requires >10 min per person, which includes a few minutes for preparation and clean up. Five minutes of rest in the unattended setting before AOBP measurement has been further used in many recent studies (Table 1). AOBP was initially defined as office blood pressure measured by an automated device for multiple readings (three times or more ), recorded automatically with the patient under rest in an undisturbed quiet room in the absence of an observer.
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