Patient Evaluation and Management According to BP Level
| BP Category (See Table 3) . | BP Screening Schedule . | Lifestyle Counseling (Weight and Nutrition) . | Check Upper and Lower Extremity BP . | ABPMa . | Diagnostic Evaluationb . | Initiate Treatmentc . | Consider Subspecialty Referral . |
|---|---|---|---|---|---|---|---|
| Normal | Annual | X | — | — | — | — | — |
| Elevated BP | Initial measurement | X | — | — | — | — | — |
| Second measurement: repeat in 6 mo | X | X | — | — | — | — | |
| Third measurement: repeat in 6 mo | X | — | X | X | — | X | |
| Stage 1 HTN | Initial measurement | X | — | — | — | — | — |
| Second measurement: repeat in 1–2 wk | X | X | — | — | — | — | |
| Third measurement: repeat in 3 mo | X | — | X | X | X | X | |
| Stage 2 HTNd | Initial measurement | X | X | — | — | — | — |
| Second measurement: repeat, refer to specialty care within 1 wk | X | — | X | X | X | X |
| BP Category (See Table 3) . | BP Screening Schedule . | Lifestyle Counseling (Weight and Nutrition) . | Check Upper and Lower Extremity BP . | ABPMa . | Diagnostic Evaluationb . | Initiate Treatmentc . | Consider Subspecialty Referral . |
|---|---|---|---|---|---|---|---|
| Normal | Annual | X | — | — | — | — | — |
| Elevated BP | Initial measurement | X | — | — | — | — | — |
| Second measurement: repeat in 6 mo | X | X | — | — | — | — | |
| Third measurement: repeat in 6 mo | X | — | X | X | — | X | |
| Stage 1 HTN | Initial measurement | X | — | — | — | — | — |
| Second measurement: repeat in 1–2 wk | X | X | — | — | — | — | |
| Third measurement: repeat in 3 mo | X | — | X | X | X | X | |
| Stage 2 HTNd | Initial measurement | X | X | — | — | — | — |
| Second measurement: repeat, refer to specialty care within 1 wk | X | — | X | X | X | X |
X, recommended intervention; —, not applicable.
ABPM is done to confirm HTN before initiating a diagnostic evaluation.
See Table 15 for recommended studies.
Treatment may be initiated by a primary care provider or subspecialist.
If the patient is symptomatic or BP is >30 mm Hg above the 95th percentile (or >180/120 mm Hg in an adolescent), send to an ED.