Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents for evaluation of suspected masked hypertension. Office BP readings are consistently <130/80 mmHg, however, home BP monitoring (HBPM) or ambulatory BP monitoring (ABPM) reveals persistent elevations ≥130/80 mmHg. Patient denies symptoms of hypertensive emergency but reports [e.g., occasional headaches, fatigue, or stress-related palpitations]. No history of established HTN diagnosis.
Clinical Examination Findings
General: Patient is in no acute distress. Cardiovascular: Regular rate and rhythm, normal S1/S2, no murmurs, rubs, or gallops. Peripheral pulses are 2+ and symmetric. No carotid bruits. Neurological: Alert and oriented x3, no focal deficits. Funduscopic exam: No hypertensive retinopathy noted. BMI: [Insert Value] kg/m².
Treatment Protocol
Initiate lifestyle modifications including DASH diet, sodium restriction (<2g/day), and regular aerobic exercise (150 min/week). Continue serial home BP monitoring (morning and evening) to confirm diagnostic criteria. Pharmacologic therapy (e.g., ACE inhibitor or ARB) to be considered if target BP remains uncontrolled despite lifestyle interventions or if evidence of end-organ damage (LVH, microalbuminuria) is present.