A patient walks into clinic after climbing two flights of stairs and registers 150/90 mmHg. Which next step best follows the guidance to distinguish transient from sustained elevations?

Order urgent echocardiography to determine whether the patient has structural heart disease as the immediate cause of the high blood pressure reading before any repeated measurements.

Immediately start antihypertensive medication based solely on the single post‑stair reading because any measurement above 140/90 is definitive for chronic hypertension regardless of circumstances.

Dismiss the elevated reading as irrelevant and give the patient written dietary advice without any follow‑up because blood pressure measured after exertion is always non‑diagnostic and never requires rechecking.

Have the patient sit quietly for 5–10 minutes and then remeasure; if still elevated on repeat visits or home monitoring, consider a hypertension diagnosis rather than relying on the immediate post‑activity reading.