When a patient is screened and blood pressure is measured as >180/110 mmHg during pre-exercise screening, what is the recommended approach?

When a patient is screened and blood pressure is measured as >180/110 mmHg during pre-exercise screening, what is the recommended approach?

• A. Proceed with exercise at reduced intensity without monitoring
• B. Monitor closely and modify the exercise intensity
• C. Begin a high-intensity program
• D. Stop all activity

Answer: (B)

The key idea is safety when blood pressure is markedly elevated at screening. A reading over 180/110 mmHg signals significant cardiovascular risk, and starting or continuing exercise without close monitoring could provoke adverse events. The best approach is to monitor closely and adjust the exercise plan accordingly—begin with lighter activity, keep a careful eye on blood pressure responses, and reassess as needed, potentially delaying or seeking medical clearance if the hypertension persists. This balances the goal of staying active with the need to protect the patient from risk. Why the other options aren’t as appropriate: proceeding at a reduced intensity without monitoring leaves you without the safeguards necessary for someone with such high BP; starting a high-intensity program would markedly increase risk; stopping all activity may be too conservative in some cases and isn’t the default recommended step in pre-screening when you can safely monitor and adjust while arranging appropriate follow-up.

The key idea is safety when blood pressure is markedly elevated at screening. A reading over 180/110 mmHg signals significant cardiovascular risk, and starting or continuing exercise without close monitoring could provoke adverse events. The best approach is to monitor closely and adjust the exercise plan accordingly—begin with lighter activity, keep a careful eye on blood pressure responses, and reassess as needed, potentially delaying or seeking medical clearance if the hypertension persists. This balances the goal of staying active with the need to protect the patient from risk.

Why the other options aren’t as appropriate: proceeding at a reduced intensity without monitoring leaves you without the safeguards necessary for someone with such high BP; starting a high-intensity program would markedly increase risk; stopping all activity may be too conservative in some cases and isn’t the default recommended step in pre-screening when you can safely monitor and adjust while arranging appropriate follow-up.