Physical Exam for High Blood Pressure
Exam Overview
A physical exam for high blood pressure also includes a medical history. The extent of the physical exam and the level
of detail in your doctor's questions depend on how high your blood pressure is
and whether you have other risk factors for heart disease. People who have many
risk factors may have a more detailed evaluation.
The physical
exam and medical history includes:
- Your medical history, to evaluate risk
factors such as smoking or family history of high blood pressure..
- Two or more blood pressure measurements. Measurements may
be taken from both the left and right arms and legs and may be taken in more
than one position, such as lying down, standing, or sitting. Multiple
measurements may be taken and averaged.
- Measurement of your weight, height, and waist..
- An exam of the retina, the light-sensitive lining at the
back of the eye.
- A heart exam.
- An exam of your legs for
fluid buildup (edema), and the pulse in several areas, including the
neck.
- An exam of your abdomen using a stethoscope. A doctor will
listen to the blood vessels in the abdomen for abnormal sounds. These sounds
may be caused by blood flow through a narrowed artery in the abdomen (abdominal
bruits).
- An exam of your neck for an enlarged
thyroid, distended neck veins, and
bruits in the
carotid arteries.
Why It Is Done
The physical exam and medical history
are done to:
- Confirm that you have
high blood pressure.
- Check for effects of
high blood pressure on organs such as the kidneys and
heart.
- Determine whether you have
risk factors for heart disease or
stroke.
- Rule out other causes of high
blood pressure (secondary hypertension), such as medicines or other medical
conditions.
Results
Blood pressure measurements are classified as
follows.
Normal (optimal)
- Systolic 119 millimeters of mercury (mm Hg)
or below
- Diastolic 79 mm Hg or below
Prehypertension
- Systolic 120–139 mm Hg
- Diastolic
80–89 mm Hg
High blood pressure (hypertension)
- Systolic 140 mm Hg or
above
- Diastolic 90 mm Hg or above
High blood pressure is also classified into
stages.
- Stage 1 high blood
pressure:
- Systolic 140–159 mm
Hg
- Diastolic 90–99 mm Hg
- Stage 2 high blood
pressure:
- Systolic 160 mm Hg or
higher
- Diastolic 100 mm Hg or higher
Other results
Your doctor might check for signs that
high blood pressure has already caused damage to your blood vessels, heart, or eyes. Your doctor might check for:
- Extra heart sounds caused by enlargement of the
heart.
- Swollen (distended) neck veins, which may point to possible
heart failure.
- Abnormal sounds when the
doctor listens to the blood vessels in the abdomen using a stethoscope. These
sounds may be caused by blood flow through a narrowed artery in the abdomen
(abdominal bruits) or a narrowed artery leading to the kidney (renal artery
stenosis) or by abnormal movement of blood through the aorta, the main artery
that carries blood from the heart to the rest of the body.
- Abnormal
sound of blood flow (bruit) or diminished or absent blood flow (pulses) in the
blood vessels of the arms and legs.
- Abnormal buildup of fluid in
the abdomen or legs (edema).
- Abnormalities of the blood vessels in
the back of the eye.
What To Think About
In most cases of high blood
pressure, the person does not have any signs of complications or secondary
causes of high blood pressure.
A
diagnosis of high blood pressure usually is based on an average of two or more
readings taken during two or more visits after an initial screening.
- Except in very severe cases, the diagnosis is
not based on a single reading.
- Two or more blood pressure
measurements, taken at follow-up doctor visits, may be needed to confirm an
initial high blood pressure reading.
- Single blood pressure readings
taken a week apart may vary due to normal changes in blood pressure and to
differences in how it is measured.
If prehypertension or high blood pressure is
diagnosed, lifestyle changes and/or drug treatment may be started.
You may need more tests to check for
secondary high blood pressure or damage to other
organs, such as the kidneys, if:
- You are young and your blood pressure is
160/100 or higher.
- You had many treatments and medicines but your
blood pressure is still 160/100 or higher.
Complete the medical test information form (PDF) (What is a PDF document?) to help you prepare for this test.
Credits
| By | Healthwise Staff |
|---|
| Primary Medical Reviewer | E. Gregory Thompson, MD - Internal Medicine |
|---|
| Specialist Medical Reviewer | Robert A. Kloner, MD, PhD - Cardiology |
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| Last Revised | November 12, 2012 |
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Last Revised:
November 12, 2012
