Evaluating Hypertension

High blood pressure is most often discovered during a routine physical examination. Fortunately, diagnosing it is relatively simple. It involves measuring a person's blood pressure periodically over several weeks or months to see if the reading remains high.

Blood pressure is taken with an inflatable arm cuff connected to a pressure-measuring unit -- a device called a manometer (sphygmomanometer). A person's blood pressure generally is not considered high unless the average of three pairs of readings in a row is elevated, each pair taken at different visits to the doctor under similar conditions.

Everyone's blood pressure normally varies through the day. And some people have a rise in blood pressure especially during visits to a doctor -- a phenomenon known as white-coat hypertension. The doctor may ask patients to record their blood pressure at home and work to provide additional data.

The doctor is also likely to:

• Ask questions about the patient's and his or her family's health.
• Do a physical examination.
• Request routine tests such as urine test (urinalysis), a blood test or an electrocardiogram (ECG), which measures the heart's electrical activity.
• Consider the need for more specialized tests to examine the heart, blood vessels and selected organs. These tests may include ultrasonography, magnetic resonance angiography, angiography, computerized tomography (CT), magnetic resonance imaging (MRI) or nuclear scanning. These tests are especially important if the doctor is looking for secondary causes of hypertension.