USPSTF Confirms Its Recommendation for Ambulatory Blood Pressure Screening

Background:  USPSTF reaffirmed its recommendation that adults should be screened for HTN.  New update adds the following…
Measure BP outside of clinical setting to confirm the diagnosis before starting BP treatment
Ambulatory BP monitoring recommended, but home monitoring with a standard home BP unit acceptable.
Most of the discordance between office-based and out-of-office readings is in the direction of higher in-office BP measurements.  This can lead to overdiagnosis and overtreatment of HTN if we depend solely on in-office measurements.
ABPM and home BP measurements have been shown to be independent predictors of adverse CV outcomes after adjustment for office BP.
Conclusions:  Out-of-office measurements not necessary for patients with multiple severely elevated BP readings in the office or hospital.  But ABPM and home monitoring may be useful options if the diagnosis is unclear.
Ann Intern Med 2015 Oct 13
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