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Hypertension confirmation — USMLE Step 3 MCQ

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EasyAmbulatory Medicine / Primary CareHypertension confirmationUSMLE Step 3

A 49-year-old man comes to establish care after two automated pharmacy blood pressure readings were high. He has no headache, chest pain, dyspnea, kidney disease, or diabetes. Office blood pressure today is 148/92 mm Hg in both arms after 5 minutes of rest. Physical examination and basic metabolic panel are normal. He asks whether he should start medication today. Which of the following is the most appropriate screening recommendation?

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

Reveal the answer and explanation

Correct answer: C — Obtain home or ambulatory blood pressure measurements before diagnosis

Hypertension should be confirmed with out-of-office measurements when feasible before long-term treatment is started, unless there is hypertensive emergency or very high-risk disease.

Reference: USPSTF Hypertension in Adults: Screening, 2021