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 |
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.