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Question preview · RCPSC IM

A 52-year-old man with no past medical history is seen in family practice for an annual review. Automated office blood pressures over two separate visits, each with three readings, average 152/94 mm Hg. He is asymptomatic and takes no medications. Physical examination is otherwise normal. What is the most appropriate next step to confirm a diagnosis of hypertension before starting drug therapy?

  1. A. Start a thiazide-like diuretic immediately
  2. B. Order 24-hour ambulatory blood pressure monitoring
  3. C. Order plasma renin and aldosterone levels
  4. D. Schedule an echocardiogram to assess left ventricular hypertrophy
  5. E. Reassure and repeat office blood pressure in one year

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