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Hypertension Diagnosis — UKMLA MCQ

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HardCardiologyHypertension DiagnosisUKMLAMRCGP AKTPARA

An 83-year-old treated for hypertension reports dizziness on standing. Blood pressure is 154/78 mmHg lying and 130/66 mmHg after standing for 2 minutes. What should guide subsequent blood-pressure management?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: C — Base the treatment target on standing pressure and review medicines and other contributors to the fall

C is correct. The systolic pressure falls by 24 mmHg after standing, exceeding the NICE threshold of 20 mmHg. Subsequent treatment targets should use standing pressure and the cause should be assessed, including medicines, hydration and autonomic or other illness. A disregards the symptomatic standing measurement. B dilutes the clinically important fall by averaging positions. D substitutes seated readings and delays reassessment. E imposes an unselective dose reduction before identifying which treatment or non-drug factor is responsible.

Reference: NICE NG136 hypertension in adults: https://www.nice.org.uk/guidance/ng136/chapter/recommendations