If a patient is “Hiding in Plain Sight” and screens positive for hypertension, it means they have been unknowingly living with high blood pressure.

If hypertension is strongly suspected but further confirmation is required, it is advisable to follow up relatively soon to obtain another blood pressure reading. The recommended timeframe for a follow up reading may vary depending on the specific clinical situation, the severity of suspected hypertension, and the presence of any associated risk factors or symptoms. A general guideline, a follow up blood pressure measurement within a few weeks is appropriate. It is important to note that a diagnosis of Hypertension is not typically based on a single blood pressure reading but rather multiple measurements taken on different occasions. This approach helps to account for potential fluctuations in blood pressure throughout the day and minimizes the influence of transient factors. Ensure the patient’s blood pressure readings always meet the diagnostic criteria for hypertension. This involves multiple elevated readings on separate occasions. These steps can be taken to address their condition:

• Call the patient back into the medical office to check their blood pressure.
• Clearly explain to the patient they have been diagnosed with hypertension, emphasizing the significance of early detection and the importance of managing blood pressure for their overall health.
• Educate the patient about hypertension, its risk factors, potential complications, and the importance of blood pressure control. Explain the importance of lifestyle modifications and, if necessary, how medications can help manage the condition effectively.
• Conduct a thorough assessment of the patient’s current lifestyle habits, including diet, physical activity, alcohol consumption, smoking, and stress levels. Identify areas for improvement and provide personalized recommendations for positive changes.
• Instruct the patient to monitor their blood pressure regularly at home using a reliable blood pressure monitor. This is called Self-Measured Blood Pressure or SMBP. Provide education/instructions on proper self-measurement techniques (e.g., correct posture and cuff placement). Teach them how to properly measure blood pressure, keep a record of their readings, and instruct them to bring them to their next visit.
• If feasible, provide the patient with a reliable home blood pressure monitor or assist the patient with where to obtain a blood pressure monitor. Ensure the monitor is validated and acceptable for accurate measurements.
• Determine the duration and frequency of SMBP monitoring. Advise the patient to measure their blood pressure at specific times of the day (per office protocol) for a defined period (e.g., several days or several weeks).
• Ask the patient to submit their SMBP readings to the clinic. Have the patient include the date, time, and blood pressure reading. Indicate the importance of consistency and adherence to the monitoring schedule.
• Assess the need for pharmacological intervention based on the patient’s blood pressure readings, overall risk profile, and response to lifestyle modifications. If necessary, prescribe appropriate antihypertensive medications, taking into consideration any comorbidities or contraindications.
• Schedule regular follow-up visits to monitor the patient’s blood pressure, evaluate the effectiveness of lifestyle modifications and medications, and make any necessary adjustments. Ensure the patient adheres to the recommended treatment plan and address any concerns or questions the patient may have.
• Provide ongoing support to the patient, addressing any barriers or challenges they may face in managing their hypertension. Offer resources, educational materials, and referrals to dieticians or support groups to aid in their journey toward blood pressure control.