How to Determine If You Have Hypertension

Three Parts:Testing for HypertensionLearning About HypertensionPreventing Hypertension

Hypertension, or high blood pressure, is a medical condition whereby systemic arterial blood pressure is chronically elevated.[1] Hypertension is often a silent disease with minimal symptoms, but increases risks for heart attack, stroke, peripheral vascular disease, eye disease, and kidney disease. It is important to know the signs of hypertension and how to prevent it when possible.

Part 1
Testing for Hypertension

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    Check your blood pressure with a blood pressure meter or sphygmomanometer. These instruments can be purchased cheaply online or in a store that sells medical equipment.[2] Alternatively, many drugstores have free blood pressure meters you can use, and some medical offices offer free blood pressure checks. Blood pressure checks are also part of a routine doctor's visit.
    • Make sure the right sized cuff is used. If the cuff is too large for the arm, the results will be falsely low. If the cuff is too small for the arm, the results will be falsely high.
    • Make sure that the cuff is at the same level as the heart.
    • Be still when the cuff is inflated. Agitation will raise peripheral resistance and falsely elevate the blood pressure measurement.
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    Record the systolic blood pressure (SBP). This is the blood pressure in vessels during a heartbeat, when the heart is pumping.[3] If a manual cuff is used, the cuff is inflated until no pulsation is heard with the stethoscope over the brachial artery, then the cuff is slowly deflated and the highest pressure at which pulsation is heard is the systolic blood pressure.
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    Record the diastolic blood pressure (DBP). This is the pressure between heartbeats, when the heart is resting.[4] If a manual cuff is used, after noting the systolic blood pressure, the cuff is slowly deflated further until no more pulsation is heard, which marks the diastolic blood pressure.
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    Monitor your blood pressure over a period of weeks to months. Realize that one reading does not confirm you have hypertension. A diagnosis of hypertension requires at least three measurements above 140/90 at least three weeks apart between the first and third measurement. Blood pressure should be consistently elevated to diagnose hypertension.[5]
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    See a health professional. Your doctor can confirm the diagnosis of hypertension and order additional tests to look for possible etiology and evidence of organ damage. Basic tests include:[6]
    • Blood urea nitrogen and creatinine and urinalysis to look for kidney damage;
    • Serum sodium, potassium, calcium, and thyroid-stimulating hormone to look for an endocrine cause for the hypertension, such as Conn's syndrome;
    • Fasting blood glucose, total cholesterol, HDL and LDL cholesterol, and triglycerides to look for presence of a metabolic disorder, such as diabetes mellitus or hypercholesterolemia;
    • Electrocardiogram and chest radiograph to look for evidence of hypertensive heart disease.
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    Be aware of "white coat hypertension." This occurs when your blood pressure spikes in the setting of a clinic or doctor's office (the "white coat" refers to the white coats doctors sometimes wear), but is relatively normal in other settings.[7] Some believe this is caused by the stress of going to the doctor's office, but some believe it is a sign that you may develop hypertension later on.[8]
    • If you experience white coat hypertension, ask your doctor about the possibility of wearing a blood pressure monitor outside of the office. The data collected by this monitor, when worn for 24 hours, can help determine if you are at risk for hypertension as a long-term issue.[9]

Part 2
Learning About Hypertension

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    Learn the symptoms of hypertension. There are usually very few, if any, symptoms of hypertension. Usually, hypertension is diagnosed by getting your blood pressure tested at the doctor’s office. The symptoms that do appear for hypertension are not the same for all people and often only surface when the hypertension has reached a critical level. These symptoms could include:[10]
    • Headaches
    • Shortness of breath
    • Nosebleeds
    • Fatigue
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    Know the stages of hypertension. If your blood pressure is above 120/80, you are considered to have hypertension, or high blood pressure. There are several stages of high blood pressure that change depending on the levels of pressure impacting the blood as it is pumped by your heart.[11]
    • 120–139/80–89 — Blood pressure in this range is considered prehypertension which tends to get worse over time but is not cause for much alarm as long as it remains at these levels.
    • 140–159/90–99 — Blood pressure in this range is considered Stage 1 Hypertension. This range of blood pressure is concerning, but manageable. You should begin considering lifestyle changes like eating a low sodium diet, losing weight, limiting alcohol consumption, and speak with your doctor about other preventative steps, including medication.
    • 160 or higher/100 or higher — Blood pressure in this range is considered Stage 2 Hypertension. This is a very dangerous level to remain at and you should schedule an appointment with your doctor immediately.
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    Learn about primary hypertension. For most people, high blood pressure just develops gradually over a period of years with no identifiable cause. This is called primary/essential hypertension.[12]
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    Be aware of the causes for secondary hypertension. Secondary hypertension is high blood pressure that is caused by some underlying condition. It develops more suddenly and has more drastic effects than primary hypertension. Some preexisting conditions that can lead to secondary hypertension include:[13]
    • Thyroid problems
    • Drug or alcohol abuse
    • Certain kinds of medications (like birth control pills, decongestants, etc.)
    • Kidney problems
    • Obstructive sleep apnea

Part 3
Preventing Hypertension

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    Quit using tobacco. Smoking and chewing tobacco raises a person's blood pressure while they are using these products[14], but they have long term effects on blood pressure as well. The chemicals in these substances can damage the lining of artery walls which can cause arteries to narrow, thereby increasing blood pressure.
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    Cut back on your alcohol intake. Drinking too much can severely damage many parts of your body including your heart and liver, but it can also lead to high blood pressure.[15]
    • Drinking alcohol can also interfere with medication you might be on to control your high blood pressure.
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    Limit your salt consumption. Too much sodium in a person's diet can cause them to retain fluid, which may increase blood pressure.[16] Limiting junk food and other foods that are high in sodium may help lower your blood pressure.
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    Consume more potassium. Potassium helps your cells balance out their sodium content/intake. If you don't consume enough potassium, your cells may hold on to too much sodium which can lead to higher blood pressure.
    • If you have high blood pressure, try eating more foods that are high in potassium like bananas, potatoes, yogurt, orange juice, lentils, pistachios, etc.[17]
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    Take a vitamin D supplement. Vitamin D can effect enzymes produced by your kidneys that affects high blood pressure,[18] so taking a vitamin D supplement can help lower your blood pressure.
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    Lower your stress levels. High levels of stress can seriously affect your body, including your blood pressure. This is especially true if you use tobacco, alcohol, or food to combat the effects of your stress.
    • Try relaxing more without these substances by reading a book, taking a bath, going for a walk, etc. This can help lower your blood pressure.

Tips

  • Isolated systolic hypertension is present when the blood pressure is ≥140/<90 mmHg and isolated diastolic hypertension is considered to be present when the blood pressure is <140/≥90 mmHg.
  • If you're over 50, blood pressure measured from the upper arm area is the most accurate.[19]
  • Blood pressure varies from moment to moment and is affected by many factors including diet, salt sensitivity, exercise, disease, drugs (such as oral contraceptives, nonsteroidal anti-inflammatory drugs, nasal decongestants, diet pills, tricyclic antidepressants), alcohol, stress, obesity or being overweight.[20]

Warnings

  • Always seek your doctor's advice and avoid self-diagnosing.

Things You'll Need

  • Blood pressure meter
  • Stethoscope

Sources and Citations

  1. The Merck Manual of Medical Information, High Blood Pressure, p. 131, (2003), ISBN 978-0-7434-7733-8
  2. http://www.practicalclinicalskills.com/sphygmomanometer.aspx
  3. https://www.nlm.nih.gov/medlineplus/magazine/issues/winter10/articles/winter10pg10a.html
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