Guidelines Summary

Screening

Guidelines on screening for hypertension have been issued by the following organizations:

U.S Preventive Services Task Force (USPSTF)

Joint National Committee (JNC)
American College of Obstetricians and Gynecologists (ACOG)
Department of Veterans Affairs (VA)/Department of Defense (DoD)
European Society of Hypertension (ESH)/European Society of Cardiology (ESC)

The 2013 joint European Society of Hypertension (ESH) and the European Society of
Cardiology (ESC) guidelines recommend that ambulatory blood-pressure monitoring (ABPM)
be incorporated into the assessment of cardiovascular risk factors and hypertension. [6, 7]

A comparison of the recommendations for blood pressure screening is provided in Table 4

below.

Table 4. Guidelines for Blood Pressure Screening in Adults (Open Table in a new window)

Issuing Screening Screening

Year Screening Interval
Organization Populations Measurement
Annually for adults
age 40 and those at
Measurements outside of
increased risk for high
the clinical setting should
blood pressure
be obtained for
including those who
diagnostic confirmation
have high-normal
before starting treatment.
blood pressure (130
139/8589 mm Hg),
are overweight or
obese, or are African
No evidence was found
Adults 18 American.
US Preventive
years without for a single gold standard
Services Task Force 2015 protocol for HBPM or
known
(USPSTF) [108]
hypertension ABPM. However, both
may be used in
Adults ages 18 to <40
conjunction with proper
years with normal
office measurement to
blood pressure
make a diagnosis and
(130/85mm Hg) with
guide management and
no known risk factors
treatment options.
should be screened
every 3-5 years

Seventh Report of the Adults ages Diagnosis based on At least once every 2
2003
Prevention, 18 years average of 2 or more years in adults with
 seated blood pressure blood pressure less
readings on each of two than 120/80 mm Hg
or more office visits and every year in those
Detection, with levels of 120
139/8089 mm Hg.

Evaluation, and

Treatment of the Joint

National Committee
on

High Blood Pressure

(JNC 7) [2]

American College of
All females Annually as part of
Obstetricians and
2013 ages 13 Office measurement routine well-woman
Gynecologists
years care
(ACOG) [109]
Office measurement;

Diagnosis based on 2
readings at 2 separate
Department of visits; For patients where Periodic, preferably
Veterans diagnosis remains annually, at time of
Affairs/Department of 2014 All adults uncertain, home blood routine preventative
Defense (VA/DoD) pressure monitoring (2-3 care or health
[110]
times a day for 7 days) or assessment;
24 hour ambulatory
monitoring to confirm
diagnosis

European Society of Office measurement;

Hypertension Diagnosis based on at
At time of routine
/European Society of least 2 readings at 2
2013 All adults preventative care or
Cardiology separate visits; Consider
health assessment
home blood pressure
monitoring or 24 hour
 ambulatory monitoring to
(ESH/ESC) [7] confirm diagnosis

Hypertension Classification

In the United States, the most widely used classification of blood pressure for adults aged 18
years or older is from the 2003 Seventh Report of the Joint National Committee on
Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC 7), as follows
[2]
:

Normal: Systolic lower than 120 mm Hg, diastolic lower than 80 mm Hg

Prehypertension: Systolic 120-139 mm Hg, diastolic 80-89 mm Hg
Stage 1: Systolic 140-159 mm Hg, diastolic 90-99 mm Hg
Stage 2: Systolic 160 mm Hg or greater, diastolic 100 mm Hg or greater