Screening And Diagnosis
You also can check your blood pressure at home with a home blood pressure measurement device, or monitor. It is important that you understand how to use the monitor properly. Below are additional things to do when taking your blood pressure at home:
- Sit with your back supported and your feet flat on the floor.
- Rest your arm on a table at the level of your heart.
- Take two readings, at least 2 minutes apart, and average the results.
High blood pressure is most often discovered during a routine physical examination. However, a single high blood pressure reading usually isn't enough for a diagnosis. You have high blood pressure only if your blood pressure readings are persistently high at two or more office visits over several weeks or months.
Everyone's blood pressure normally varies throughout the day. And some people have a rise in blood pressure especially during visits to a doctor — a phenomenon known as white-coat hypertension. That's why it's important to take more than one reading and on more than one occasion. Your doctor may ask you to record your blood pressure at home and at work to provide additional information.
For years health professionals tended to focus on diastolic pressure, which is the bottom number. The theory was this: The body can tolerate occasional increases in systolic pressure, but diastolic pressure that stays consistently high can lead to organ damage. However, this theory has been revised. A high systolic reading is now considered an equally important value and a more important number for people older than 50. In fact, many people have a normal diastolic level but an elevated systolic level. This type of high blood pressure is called isolated systolic hypertension (ISH). In people older than 55, the pulse pressure — the difference between the systolic and diastolic pressures — is an important predictor of health risks as well.
If you have any type of high blood pressure, your doctor is likely to do the following:
- Ask you questions about your health and your family's health (a health history).
- Do a physical examination.
- Ask you to have routine tests such as a urine test (urinalysis), a blood test and an electrocardiogram (ECG), which measures your heart's electrical activity.
- Consider the need for more specialized tests to examine blood flow. These tests may include ultrasonography, magnetic resonance angiography, angiography, computerized tomography (CT), magnetic resonance imaging (MRI) or nuclear scanning. They're especially important if your doctor is looking for secondary causes of hypertension.