Optimal hypertension screening frequency in adults: a systematic review

Blood pressure measurement for hypertension (HTN) screening is routine practice in primary care. The question remains regarding the optimal frequency of measurement to ensure accurate diagnosis while avoiding unnecessary repeated assessments.

To determine the optimal frequency of HTN screening in adults.

A systematic review was conducted in accordance with PRISMA guidelines. PubMed, Embase, Cochrane CENTRAL, and LiSSa databases were searched using standardized search strategies. The selection process was illustrated using a PRISMA 2020 flow diagram. Included studies were summarized in tables and qualitatively synthesized. The risk of bias of the included studies was assessed using the JBI critical appraisal tools. The initial search was conducted in April 2024, with an updated search performed in January 2026. To improve search sensitivity, an additional targeted search using controlled vocabulary and free-text terms was conducted in May 2026 in PubMed and Embase.

Two studies were identified through database searches: a prospective cohort study assessing blood pressure variability over time to determine the optimal screening interval for HTN, and a case-control study comparing the sensitivity and specificity of blood pressure measurement at each visit with those of annual measurement for HTN diagnosis. Six additional guideline publications were analyzed to provide an overview of existing international recommendations on this topic. Existing recommendations overall correspond to grade C-level recommendations, largely based on expert opinion.

There is a paucity of primary research specifically addressing the optimal frequency of HTN screening. No study evaluating the impact of different screening frequencies on the incidence of HTN-related complications was identified. Available evidence is therefore limited and indirect.