What does the hypertension screening involve?

From the Guidelines

A hypertension screen involves measuring blood pressure to detect high blood pressure (hypertension), and according to the most recent guidelines, it should be intermittently repeated, e.g., every 3 years, with more frequent checks in individuals 40 years or older and those with elevated blood pressure 1. The process typically includes taking at least two blood pressure readings while seated after 5 minutes of rest, using a properly sized cuff placed on the bare upper arm at heart level. For diagnosis, readings are usually taken on two or more separate occasions, as a single elevated reading doesn't necessarily indicate hypertension. The screening may also include a medical history review, physical examination, and sometimes laboratory tests (blood and urine tests) to check for underlying causes and assess organ damage. Home blood pressure monitoring or 24-hour ambulatory monitoring might be recommended for more accurate assessment. Hypertension is diagnosed when systolic pressure consistently measures 130 mmHg or higher, or when diastolic pressure is 80 mmHg or higher. Some key points to consider when screening for hypertension include:

• Opportunistic BP screening in a primary care setting appears effective, with an estimated 90% of all adults aged >40 years in the UK having a BP check within a 5-year time period 1.
• The benefits of screening for high blood pressure in adults to prevent cardiovascular morbidity and mortality are substantial, and the harms of screening are small 1.
• Regular screening is important because hypertension often has no symptoms but significantly increases the risk of heart disease, stroke, kidney disease, and other serious health problems if left untreated. Some populations may require more frequent screening, such as:
• Individuals 40 years or older
• African Americans of any age
• Persons who are overweight or obese
• Those with a family history of hypertension
• Those with other risk factors, such as diabetes or kidney disease It's essential to follow the most recent guidelines and recommendations for hypertension screening, as they are based on the latest evidence and are designed to optimize patient outcomes 1.

From the Research

Hypertension Screening Methods

• The hypertension screen involves measuring blood pressure using various methods, including:
  • Clinic blood pressure measurement using the auscultatory method and a mercury sphygmomanometer 2
  • Home blood pressure monitoring 3
  • 24-hour ambulatory blood pressure monitoring 3
• These methods can help evaluate the risk of target-organ damage and hypertension-related morbidity and mortality 3

Blood Pressure Measurement Devices

• Automated sphygmomanometers are commonly used for their convenience and ease of use 4
• However, manual blood pressure measurement skills using a mercury sphygmomanometer are still valuable, particularly when a clinical decision is based on the blood pressure readings 2
• The choice of device depends on the clinical need and the availability of equipment 4

Importance of Accurate Blood Pressure Measurement

• Accurate blood pressure measurement is crucial for diagnosing and managing hypertension 5
• Reducing blood pressure to less than 140/90 mm Hg can reduce the risk of all-cause and cardiovascular mortality in adults with hypertension 5
• Lowering blood pressure to less than 135/85 mm Hg may further reduce the risk of myocardial infarction 5