If, after further evaluation, hypertension is not confirmed, these steps should be considered
- Conduct multiple blood pressure measurements with a lower detection threshold (based on those enumerated in ACC/AHA guidelines) which refers to the level at which hypertension is considered to be detectable or clinically significant. It indicates the point at which medical professionals should initiate diagnostic testing or interventions for hypertension on separate occasions to rule out any isolated or temporary spikes in blood pressure. Explore alternative explanations for the initial positive screening. Consider conditions that can lead to elevated blood pressure readings, such as white coat hypertension (elevated blood pressure in a clinical setting), anxiety, pain, caffeine intake, or certain medications.
- If hypertension is ruled out, establish a suitable follow-up plan to monitor the patient’s blood pressure periodically and assess their overall health. Determine the appropriate frequency of follow-up visits (repeat Self-Measured Blood Pressure (SMBP)/Automated Office Blood Pressure (AOBP) in 3-6 months) based on the patient's specific circumstances and risk factors.
- Even if hypertension is not confirmed, it is important to encourage the patient to maintain a healthy lifestyle. Emphasize the benefits of regular physical activity, a balanced diet, weight management, stress reduction, and smoking cessation (if applicable) to promote overall well-being and cardiovascular health. Use this opportunity to address any other health concerns identified during the evaluation, and provide guidance, educational resources, and interventions as needed.
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