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To determine the accuracy and reproducibility of a new automated blood pressure manometer (BpTRU) relative to auscultatory blood pressure assessed by a research nurse and to that assessed by a clinic nurse.Firefighters in a cohort study had blood pressure assessed on up to five occasions with BpTRU and by a trained research technician. Patients in an internal medicine clinic had blood pressure assessed by the clinic nurse and by BpTRU. The absolute values of blood pressure, reproducibility and effect on hypertension classification were compared with the different methods.The research technician readings were higher than the BpTRU readings at visit 1 (3.0/2.7 mmHg, P<0.0001) but the readings converged by visits 4–5 because of a greater reduction in the research nurse readings. The BpTRU readings had similar reproducibility and classification of hypertension as the research technician but did not exhibit terminal digit preference while the research technician readings did. The BpTRU had substantially lower readings (8/7 mmHg) and fewer hypertensive readings than those of the nurse in the internal medicine clinic.This preliminary study found that the BpTRU had desirable characteristics that suggest that it would be a suitable replacement for auscultatory assessment of blood pressure in clinical practice. A large confirmatory study performed in a usual clinic setting is required.