A dual mode automatic device for delivery of remote ischemic preconditioning treatment includes a cuff and a controller configured to deliver a first regular treatment protocol or a second extended treatment protocol. Switching to an extended treatment protocol may be done by an operator for selected groups of patients such as elderly or patients with diabetes. Automatic determination of the best mode is also disclosed. Optimal delivery of remote ischemic preconditioning treatment in this individualized patient-specific manner provides strong ischemic protection to a greater number of patients.