Diagnosis

A blood pressure test diagnoses elevated blood pressure. This often involves an inflatable arm cuff placed around your arm and a pressure-measuring gauge.

A blood pressure reading, given in millimeters of mercury (mm Hg), has two numbers. The first, or upper, number measures the pressure in your arteries when your heart beats (systolic pressure). The second, or lower, number measures the pressure in your arteries between beats (diastolic pressure).

Your blood pressure is considered normal if it's below 120/80 mm Hg. Other blood pressure measurements are categorized as:

  • Elevated blood pressure. Elevated blood pressure is a systolic pressure ranging from 120 to 129 mm Hg and a diastolic pressure below 80 mm Hg. Elevated blood pressure tends to get worse over time unless steps are taken to control blood pressure.
  • Stage 1 hypertension. Stage 1 hypertension is a systolic pressure ranging from 130 to 139 mm Hg or a diastolic pressure ranging from 80 to 89 mm Hg.
  • Stage 2 hypertension. More-severe hypertension, stage 2 hypertension, is a systolic pressure of 140 mm Hg or higher or a diastolic pressure of 90 mm Hg or higher.

Because blood pressure tends to fluctuate, a diagnosis of elevated blood pressure is based on the average of two or more blood pressure readings taken on separate occasions in a consistent manner. The first time, your blood pressure generally should be measured in both arms to determine if there's a difference. After that, the arm with the higher reading should be used.

Your doctor might suggest a 24-hour blood pressure monitoring test called ambulatory blood pressure monitoring. The device used for this test measures your blood pressure at regular intervals over 24 hours and provides a more accurate picture of blood pressure changes over an average day and night. However, these devices aren't available in all medical centers, and insurance rarely covers them.

Your doctor might also recommend that you use a home blood pressure monitor, preferably one that can store your readings in its memory, to check your blood pressure regularly. If so, he or she should show you how to use it properly.

Treatment

If you have elevated blood pressure accompanied by diabetes, kidney disease or cardiovascular disease, your doctor might recommend blood pressure medication in addition to lifestyle changes.

If you've been diagnosed with elevated blood pressure, the benefits of medication are less clear. If you have stage 1 or stage 2 hypertension, your doctor will likely prescribe medications. Lifestyle changes to help control your elevated blood pressure include:

  • Getting to and maintaining a healthy weight
  • Eating a healthy, low-salt diet
  • Exercising regularly
  • Limiting the amount of alcohol you drink
  • Quitting smoking

Clinical trials

Explore Mayo Clinic studies testing new treatments, interventions and tests as a means to prevent, detect, treat or manage this disease.

Lifestyle and home remedies

As your blood pressure increases, so does your risk of cardiovascular disease. That's why it's so important to control elevated blood pressure. The key is a commitment to healthy lifestyle changes.

  • Eat healthy foods. Eat a healthy diet. Try the Dietary Approaches to Stop Hypertension (DASH) diet. Choose fruits, vegetables, whole grains, poultry, fish and low-fat dairy foods. Get plenty of potassium, which can help lower blood pressure. Eat less saturated fat and trans fat.
  • Maintain a healthy weight. Keeping a healthy weight, or losing weight if you're overweight or obese, can help you control your blood pressure and lower your risk of related health problems. In general, you may reduce your blood pressure by about 1 mm Hg with each kilogram (about 2.2 pounds) of weight you lose.
  • Use less salt. Aim to limit sodium by at least 1,000 mg a day. A lower sodium intake — 1,500 mg a day or less — is ideal for most adults.

    Besides putting down the saltshaker, read labels and pay attention to the amount of salt that's in the processed foods you eat, such as canned soups or frozen dinners.

  • Increase physical activity. Regular physical activity can help lower your blood pressure, manage stress, reduce your risk of other health problems and keep your weight under control.

    For most healthy adults, the Department of Health and Human Services recommends that you get at least 150 minutes a week of moderate aerobic activity or 75 minutes a week of vigorous aerobic activity, or a combination of moderate and vigorous activity. Aim to do muscle-strengthening exercises at least two days a week.

  • Limit alcohol. If you drink alcohol, do so in moderation. For healthy adults, that means up to one drink a day for women of all ages and men older than age 65, and up to two drinks a day for men age 65 and younger. One drink equals 12 ounces (355 milliliters) of beer, 5 ounces (148 milliliters) of wine or 1.5 ounces (44 milliliters) of 80-proof liquor.
  • Don't smoke. Tobacco injures blood vessel walls and speeds up the process of hardening of the arteries. If you smoke, ask your doctor to help you quit.
  • Manage stress. Reduce stress as much as possible. Practice healthy coping techniques, such as muscle relaxation, deep breathing or meditation. Getting regular physical activity and plenty of sleep can help, too.

Preparing for your appointment

If you think you may have elevated blood pressure or high blood pressure, make an appointment with your family doctor to have your blood pressure checked.

No special preparations are necessary. To get an accurate reading, avoid caffeinated food and drinks, exercise and tobacco for at least 30 minutes before your test. You might want to use the toilet before having your blood pressure measured.

Because some medications — such as over-the-counter cold medicines, pain medications, antidepressants, birth control pills and others — can raise your blood pressure, bring a list of all medications, vitamins and other supplements you take and their doses to your doctor's appointment. Don't stop taking any prescription medications that you think might affect your blood pressure without your doctor's advice.

Here's some information to help you get ready for your appointment.

What you can do

Make a list of:

  • Your symptoms, if you have any, even if they seem unrelated to the reason you scheduled the appointment, and when they began
  • Key personal information, including a family history of high blood pressure, high cholesterol, heart disease, stroke or diabetes, and any major stresses or recent life changes
  • Write down questions to ask your doctor.

For elevated blood pressure, questions to ask your doctor include:

  • What tests do I need?
  • Do I need to take medication?
  • What foods should I eat or avoid?
  • What's an appropriate level of physical activity?
  • How often do I need to have my blood pressure checked?
  • Should I monitor my blood pressure at home?
  • I have these other health conditions. How can I best manage them together?
  • Are there brochures or other printed material that I can have? What websites do you recommend?

Don't hesitate to ask other questions.

What to expect from your doctor

Your doctor is likely to ask you a number of questions, including:

  • What are your diet and exercise habits like?
  • Do you drink alcohol? How many drinks do you have in a week?
  • Do you smoke?
  • When did you last have your blood pressure checked? What was your blood pressure measurement then?
Oct. 05, 2018
References
  1. High blood pressure. National Heart, Lung, and Blood Institute. https://www.nhlbi.nih.gov/health-topics/high-blood-pressure. Accessed Sept. 17, 2018.
  2. Whelton PK, et al. 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA Guideline for the prevention, detection, evaluation and management of high blood pressure in adults. Hypertension: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. 2018;71:E13.
  3. Flynn JT, et al. Clinical practice guideline for screening and management of high blood pressure in children and adults. Pediatrics. 2017;140:e20171904.