USPSTF Recommendations for Screening for HTN in Adults

Apr 29, 2021   |  Sandra M. Oliver-McNeil, DNP, ACNP-BC, FACC
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Authors:
Krist AH, Davidson KW, Mangione CM, et al., on behalf of the US Preventive Services Task Force.
Citation:
Screening for Hypertension in Adults: US Preventive Services Task Force Reaffirmation Recommendation Statement. JAMA 2021;325:1650-6.

The following are key points to remember from this recommendation statement on screening for hypertension (HTN) in adults from the US Preventive Services Task Force:

  1. The definition of HTN varies by organizations. HTN is defined as being ≥140/90 mmHg or ≥130/80 mmHg.
  2. All adults should be screened for HTN, risk factors that increase a person’s risk for the condition, and dietary factors.
  3. Risk factors include older age, Black race, family history, excess weight and obesity, lack of physical activity, stress, and tobacco use.
  4. Dietary factors include a diet high in fat or sodium, a diet low in potassium, or excessive alcohol intake.
  5. Research supports obtaining office blood pressure measurements at the brachial artery (upper arm) with the patient in the sitting position after 5 minutes of rest and medical personnel present during measurement.
  6. Ambulatory blood pressure monitoring and home blood pressure monitoring with validated and accurate devises should be used outside of clinical setting to confirm diagnosis.
  7. HTN screening should be done annually in adults >40 years old and adults with increased risk for HTN.
  8. Screening every 3-5 years is appropriate for adults 18-39 years who are not at increased risk HTN and have a documented normal blood pressure.
  9. Treatment can include lifestyle changes, pharmacotherapy, or both. Treatment should be based on age, risk factors, and severity of HTN.
  10. An accompanying editorial noted that coronavirus disease 2019 has impacted the ability to screen high-risk groups for HTN and highlighted racial/ethnic health disparities.

Clinical Topics: Cardiovascular Care Team, COVID-19 Hub, Diabetes and Cardiometabolic Disease, Prevention, Diet, Hypertension

Keywords: Hypertension, Blood Pressure, Blood Pressure Monitoring, Ambulatory, Blood Pressure Determination, Adult, Risk Factors, Diet, Sedentary Behavior, Sodium, Dietary, Obesity, African Americans, Alcohol Drinking, Tobacco Use, Potassium, COVID-19, severe acute respiratory syndrome coronavirus 2


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