Exams and Tests
In most cases, extensive tests are
not needed to diagnose
high blood pressure. If a blood pressure measurement
shows your
systolic and/or
diastolic blood pressure is high, usually two more
measurements at separate times will be done to confirm that you have high blood
pressure.
Routine tests
A
physical exam and a
medical history are routinely used to evaluate high
blood pressure. Before treatment is started, other blood tests and urine tests,
such as
urinalysis, may be done to find out whether there has
been damage to organs and to check for complications. These lab tests may
include measurements of potassium,
sodium (a component of salt), glucose (blood sugar),
cholesterol levels, and
tests to measure kidney function.
Electrocardiogram (EKG, ECG) also may be done to find
out whether there is any damage to the heart. Your doctor may want to check
your risk of
coronary artery disease.
In most people who have high blood pressure without
any complications, routine lab test results will be normal. Sometimes, findings
may suggest kidney disease,
diabetes, or a
hormone disorder.
If there is reason to
suspect that blood pressure measurements taken in the doctor's office do not
represent your accurate blood pressure (for example, if you may have
white-coat hypertension), you may need to get your
blood pressure measured away from the doctor's office.
In some
cases, you may be asked to check your blood pressure at home and keep a record
of the readings. If you are not able to measure your blood pressure accurately
at home, you may need
ambulatory blood pressure monitoring.
If
your blood pressure is higher than 135/80, your doctor will likely ask you to
get a test for diabetes.2
Early detection
Screening tests and programs for
high blood pressure vary widely in reliability. Results from automated blood
pressure testing, such as you might do at a grocery store or pharmacy, may not
be accurate. Any high blood pressure measurement discovered during a blood
pressure screening program needs to be confirmed by a doctor or another health
professional.
Rechecking blood pressure
The Seventh Joint National Committee (JNC 7) on
Prevention, Detection, Evaluation, and Treatment of High Blood Pressure
recommends:1
- Healthy adults with normal blood pressure
(119/79 millimeters of mercury [mm Hg] or below) should have their blood
pressure checked at least every 1 to 2 years. This can be done during any
routine medical visit.
- Adults who are prehypertensive (120–139
and/or 80–89 mm Hg) should have their blood pressure checked as often as
recommended by their doctor, or at least yearly. This can be done during any
routine medical visit.
- Adults with other
risk factors for heart disease or evidence of disease caused by high blood
pressure need to have their blood pressure checked more often.