Take Second (and Maybe Third) BP Readings in Routine Follow-Up for Hypertension

The American Heart Association recommends that at least two blood pressure (BP) readings be taken 1 to 2 minutes apart in routine office practice (NEJM JW Gen Med Dec 15 2017 and J Am Coll Cardiol 2017 Nov 13; [e-pub]), but repeat readings often are skipped. In this Ohio study, researchers assessed the value of second readings at 81,000 primary care visits for patients with hypertension during a single year. Initial measurements were ≥140/90 mm Hg at 39% of visits.

Second readings were taken after 26,000 initially elevated values, and 36% of second readings were <140/90 mm Hg; median improvement in systolic BP was 8 mm Hg. The likelihood of a normal second reading depended on the degree of elevation in the first reading. For example, among p…