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Hypertension — USMLE Step 3 MCQ

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ModerateAmbulatory Medicine / Primary CareHypertensionUSMLE Step 3

At a routine visit, a 52-year-old man has blood pressure readings of 148/92 and 146/90 mm Hg. He has no symptoms and takes no medications. His BMI is 31 kg/m2, and serum creatinine and electrolytes are normal. Review of prior records shows one reading of 150/94 mm Hg 1 year ago. There is no evidence of end-organ damage. Which of the following is the most appropriate next step in management?

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Correct answer: A — Arrange validated home or ambulatory blood pressure monitoring

Elevated office blood pressure should be confirmed with out-of-office measurement before diagnosing hypertension in an asymptomatic adult without urgent features.

Reference: USPSTF A and B Recommendations, 2025-2026: https://www.uspreventiveservicestaskforce.org/uspstf/recommendation-topics/uspstf-a-and-b-recommendations