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.