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April 27, 2021

USPSTF Recommendations for Screening for Hypertension in Adults: It Is Time to Unmask Hypertensive Risk

Author Affiliations
  • 1Department of Family Medicine and Community Health, Duke University, Durham, North Carolina
  • 2Center for Novel and Exploratory Clinical Trials, Yokohama City University, Yokohama, Kanagawa, Japan
  • 3Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois
JAMA Cardiol. 2021;6(8):869-871. doi:10.1001/jamacardio.2021.1122

Hypertension is a highly prevalent condition, affecting nearly 50% of the US adult population,1,2 and it is a major, modifiable risk factor for coronary heart disease, stroke, kidney disease, and heart failure.1,3 Most people with hypertension have no signs or symptoms; therefore, hypertension is usually detected through screening. However, blood pressure (BP) levels vary physiologically throughout the day and night, so characterizing an individual’s true or accurate BP level is challenging.4 It is possible to measure BP levels in different settings, including in the clinician’s office, using self-monitoring at home, or via ambulatory monitoring over 24 hours, expanding the possible means for detecting and defining hypertension. To date, BP levels measured in the office setting have been the primary approach to diagnose hypertension and guide the initiation and titration of antihypertensive medication. However, for many individuals, BP levels differ substantially when measured inside vs outside the office.

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