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Hypertension diagnosis — MCCQE Part 1 MCQ

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ModerateHypertensionHypertension diagnosisMCCQE Part 1

A 54-year-old woman has repeated office BP readings around 156/94 mmHg but feels well. She has no end-organ symptoms, ECG is normal, and creatinine is normal. She is anxious in clinic and has no home readings. What is the most appropriate investigation?

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Correct answer: C — Confirm hypertension with validated home or ambulatory blood pressure monitoring

Hypertension should be confirmed with proper out-of-office measurement when there is no emergency, because white-coat hypertension is common. Hypertensive emergency requires acute end-organ injury, which is absent here. Renal artery imaging is not first-line without resistant hypertension or suggestive features. Single casual readings are insufficient for diagnosis.

Reference: Hypertension Canada 2025 Primary Care Guideline