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Diagnosing High Blood Pressure

Hypertension, or high blood pressure, is often called a "silent disease" because you usually don't know that you have it. There may be no symptoms or signs. Nonetheless, it damages the body and eventually may cause problems like heart disease.

Therefore, it's important to regularly monitor your blood pressure, especially if it has ever been high or above the "normal" range, or if you have a family history of hypertension. Because hypertension can cause heart disease, you may also need to be tested for heart disease.

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Understanding High Blood Pressure -- the Basics

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Measuring Blood Pressure

You can get your blood pressure measured by a health care provider, at a pharmacy, or you can purchase a blood pressure monitor for your home.

Blood pressure is most often measured with a device known as a sphygmomanometer, which consists of a stethoscope, arm cuff, dial, pump, and valve.

Blood pressure is measured in two ways: systolic and diastolic.

  • Systolic blood pressure is the maximum pressure during a heartbeat.
  • Diastolic blood pressure is the lowest pressure between heartbeats.

Blood pressure is measured in millimeters of mercury (mm Hg) and is written systolic over diastolic (for example, 120/80 mm Hg, or "120 over 80"). According to the most recent guidelines, a normal blood pressure is less than 120/80 mm Hg. Hypertension is blood pressure that is greater than 140/90. For people over age 60, high blood pressure is defined as 150/90 or greater. Prehypertension consists of blood pressure that is 120 to 139/80 to 89.

Blood pressure may increase or decrease, depending on your age, heart condition, emotions, activity, and the medications you take. One high reading does not mean you have high blood pressure. It is necessary to measure your blood pressure at different times, while you are resting comfortably for at least five minutes. To make the diagnosis of hypertension, at least three readings that are elevated are usually required.

In addition to measuring your blood pressure, your doctor will ask about your medical history (whether you've had heart problems before), assess your risk factors (whether you smoke, have high cholesterol, diabetes, etc.), and talk about your family history (whether any members of your family have had high blood pressure or heart disease).

Your doctor will also conduct a physical exam. As part of this exam, he or she may use a stethoscope to listen to your heart for any abnormal sounds and your arteries for a whooshing or swishing sound that may indicate that the artery may be partially blocked. Your doctor may also check the pulses in your arm and ankle to determine if they are weak or even absent.

If you're diagnosed with high blood pressure, your doctor may recommend other tests, such as:

  • Electrocardiogram (EKG or ECG): A test that measures the electrical activity, rate, and rhythm of your heartbeat via electrodes attached to your arms, legs, and chest. The results are recorded on graph paper.
  • Echocardiogram: This is a test that uses ultrasound waves to provide pictures of the heart's valves and chambers so the pumping action of the heart can be studied and measurement of the chambers and wall thickness of the heart can be made.

 

 

WebMD Medical Reference

Reviewed by Elizabeth Klodas, MD, FACC on May 08, 2012
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