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. Additional blood tests and urine tests, such as
urinalysis, also may be done before starting treatment
to determine 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
determine 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 the presence of 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 3 times a day 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.
The U.S. Preventive Services Task Force recommended that people
with high blood pressure or high cholesterol be routinely screened for
diabetes. This recommendation is based on studies that
show early detection and treatment of diabetes substantially decreases the risk
of coronary artery disease in these people.7
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 or blood vessel disease or evidence of disease caused
by high blood pressure need to have their blood pressure checked more
often.