A 52-year-old patient has a consistently elevated blood pressure reading of 150/95 mm Hg in the clinic but reports normal readings at home averaging 120/80 mm Hg. The nurse suspects what type of hypertension,

A. Malignant hypertension is a severe and rapidly progressing form of hypertension characterized by very high blood pressure (usually >180/120 mm Hg) and signs of organ damage, such as vision changes, neurological deficits, or renal impairment. This patient’s home readings are normal, and there is no evidence of organ damage, so malignant hypertension is unlikely. B. White coat hypertension occurs when a patient’s blood pressure readings are elevated in a clinical setting due to anxiety or stress from being in a medical environment, but home or ambulatory readings are normal. The patient’s clinic reading of 150/95 mm Hg versus home readings averaging 120/80 mm Hg fits this pattern, indicating a need for home or ambulatory monitoring before initiating pharmacologic therapy. C. Primary (essential) hypertension is chronically elevated blood pressure without an identifiable secondary cause. In this patient, home readings are normal, suggesting the hypertension may not be sustained, making primary hypertension less likely. D. This occurs only in pregnant patients, usually developing after 20 weeks of gestation, and is associated with proteinuria and other systemic symptoms. This patient is 52 years old and likely postmenopausal, so pregnancy-induced hypertension is not applicable.