TABLE 11

Patient Evaluation and Management According to BP Level

BP Category (See Table 3)BP Screening ScheduleLifestyle Counseling (Weight and Nutrition)Check Upper and Lower Extremity BPABPMaDiagnostic EvaluationbInitiate TreatmentcConsider Subspecialty Referral
NormalAnnualX
Elevated BPInitial measurementX
Second measurement: repeat in 6 moXX
Third measurement: repeat in 6 moXXXX
Stage 1 HTNInitial measurementX
Second measurement: repeat in 1–2 wkXX
Third measurement: repeat in 3 moXXXXX
Stage 2 HTNdInitial measurementXX
Second measurement: repeat, refer to specialty care within 1 wkXXXXX
  • X, recommended intervention; —, not applicable.

  • a ABPM is done to confirm HTN before initiating a diagnostic evaluation.

  • b See Table 15 for recommended studies.

  • c Treatment may be initiated by a primary care provider or subspecialist.

  • d 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.