# Adult Hypertension Screening

**Purpose of Protocol:**
The purpose of this protocol, reaffirmed by the US Preventive Services Task Force (USPSTF) in 2021, is to provide guidance on screening for hypertension in adults. This comes in light of hypertension being a prevalent condition affecting approximately 50% of the adult U.S. population and serving as a major risk factor for heart failure, myocardial infarction, stroke, and chronic kidney disease.

**Studied Group:** 
The protocol targets adults aged 18 years or older who have no known diagnosis of hypertension.

**Recommended Actions:**
1. **Screening for Hypertension:** 
   - Adults should be screened with office blood pressure measurement (OBPM).
   - The USPSTF recommends an annual screening for those 40 years or older and those at increased risk for hypertension (such as African Americans, those with high-normal blood pressure, or those who are overweight or obese).
   - For adults aged 18 to 39 years not at increased risk and with a prior normal blood pressure reading, screening is recommended less frequently, between every 3 to 5 years.

2. **Confirmation Before Treatment:**
   - It’s recommended to confirm a hypertension diagnosis through blood pressure measurements outside of the clinical setting before starting any treatment.
   - Methods for such measurements include ambulatory blood pressure monitoring (patients wear a device that takes blood pressure measurements at regular intervals over 12 to 24 hours) and home blood pressure monitoring (patients measure their own blood pressure at home with an automated device).

**Implementation Considerations:**
- Blood pressure measurements should ideally be taken at the brachial artery (upper arm) with a validated device, in a seated position after 5 minutes of rest.
- This protocol reaffirms the USPSTF’s 2015 recommendation and is supported by evidence showing the substantial net benefit of screening for hypertension in reducing the incidence of cardiovascular events.

The protocol also highlights the importance of considering individual risk factors such as age, race, family history, lifestyle habits, and dietary factors when assessing someone's risk for hypertension. The recommendation is a part of a broader effort by the USPSTF to address cardiovascular health, which includes several other recommendations related to diet, physical activity, use of statins, and aspirin for prevention of cardiovascular disease and colorectal cancer, among others.