Hypertension: Working with Your Doctor
Diagnosing Your Condition
When You have Your Blood Pressure Measured...
Routine Tests for Hypertension
Tips for Working with Your Doctor
Your Hypertension Team
Diagnosing Your Condition
The best way to manage hypertension is to work with your doctor in managing your condition. Your doctor's role in this partnership is to provide medical advice, suggest treatment options and recommend resources. Your role is to monitor your blood pressure, report changes to your doctor, and manage your condition on a daily basis.
Your doctor will check for hypertension using a quick, simple and painless blood pressure test. A blood pressure cuff called a sphygmomanometer (sfig'-mo-ma-nom-e-ter) is placed around your upper arm and then inflated with air until blood flow stops. The cuff is then deflated slowly, allowing the blood to start flowing again. A stethoscope is placed at your inner elbow to listen to blood flowing through the large artery located in that area.
The first "thump" heard through the stethoscope is used to measure the pressure of blood against the blood vessel wall when the heart is pumping. This is called the systolic blood pressure. When the thumping sound can no longer be heard, the diastolic blood pressure is measured. This is the blood pressure against the blood vessel wall when the heart is relaxed ("at rest") and filling up with blood.
Blood pressure is measured in millimeters of mercury (mm Hg). When reporting blood pressure, systolic blood pressure is the first (or top) reading. Diastolic is the second (or bottom) reading.
Blood pressure classifications for adults 18 years and older are:
- Optimal blood pressure: systolic blood pressure less than or equal to 120 mm Hg, and diastolic blood pressure less than or equal to 80 mm Hg (120/80).
- Normal blood pressure: systolic blood pressure below 130 mm Hg, and diastolic blood pressure less than 85 mm Hg (130/85).
- Borderline (high-normal) blood pressure: systolic blood pressure is between 130 to 139 mm Hg, and diastolic blood pressure between 85 to 89 mm Hg (130/85 to 139/89). If your blood pressure is within these levels, your chances of developing hypertension are greater.
- Hypertension: systolic blood pressure at or above 140 mm Hg, and diastolic blood pressure at or above 90 mm Hg (140/90).
A diagnosis of hypertension is made only when three or more blood pressure tests, measured 1 to 2 weeks apart, indicate high blood pressure.
Hypertension is categorized into the following 3 stages of severity. Be aware that regardless of the stage, hypertension is dangerous and must be treated.
| Severity of Hypertension |
Systolic Pressure |
Diastolic Pressure |
| Stage 1 |
140 to 159 mm Hg |
90 to 99 mm Hg |
| Stage 2 |
160 to 179 mm Hg |
100 to 109 mm Hg |
| Stage 3 |
180 mm Hg or higher |
110 mm Hg or higher |
Hypertension treatment varies depending on:
- how high your blood pressure is;
- if any of your organs have been damaged;
- if you have risk factors for other diseases (especially heart disease and diabetes); and/or
- if you are pregnant
When you have your blood pressure measured...
- Don't drink coffee or smoke tobacco at least 30 minutes before having your blood pressure tested. One of the best things you can do for your health is to stop smoking.
- Wear short sleeves or loose clothing so that your arm is easily exposed.
- A full bladder can change your blood pressure reading, so try to urinate before your test.
- Get two readings taken at least two minutes apart and average the two results.
- Know your blood pressure. Ask your physician or nurse to tell you your blood pressure reading.
Important Note: If you experience high blood pressure only when you visit your physician ("white coat hypertension"), your doctor may ask you to monitor your blood pressure at home. Ask your doctor or nurse to check if the blood pressure cuff is working properly, and to teach you how to use it. Electronic monitors might also be available. People who cannot accurately measure their blood pressure are usually asked to wear an ambulatory blood pressure monitor. This device is usually worn for 24 hours, and takes a blood pressure reading every 30 minutes.
Routine Tests for Hypertension
If you have been diagnosed with hypertension, your physician will usually conduct blood and urine tests to determine whether the hypertension has damaged any of your body's organs. Your doctor will also check for other complications. These complications may include diabetes, chronic kidney disease, or a hormone disorder.
Sometimes an echocardiogram will be done to look at the structure and function of the heart muscle and heart valves. This is a painless and noninvasive way to assess whether the high blood pressure has started to damage the heart. A chest x-ray might also be ordered to determine if any damage to the lungs has occurred.
Along with your blood pressure reading, the results of the tests will enable your physician to determine which treatment is best for you.
Tips for Working with Your Doctor
- Choose your family doctor carefully. Look for someone who is knowledgeable about hypertension and who is interested in working cooperatively with you. Your doctor should be familiar with the latest clinical guidelines and standards for hypertension care.
- Learn as much as you can about hypertension so you can ask questions and identify problems that may need extra attention.
- Be your own advocate. Understand what type of care is recommended for people with hypertension and ask your doctor about it.
- Work with your doctor to set goals for better management of your condition.
- Meet with a hypertension educator to learn more about all aspects of hypertension, including how to manage your illness.
- Make sure you understand what medicines you should be taking, why they have been prescribed, how to take them, and possible side effects.
- If you find it difficult to follow your doctor's instructions or are reluctant to take a prescribed medication because of side effects, be sure to tell your doctor.
- Keep a health diary or log-book to help you remember medications, activities, and appointments and to record symptoms or changes in your condition.
- Take responsibility for your own health. This may include making necessary lifestyle changes, taking your medications properly, and quitting smoking.
- Don't hesitate to express concerns or ask questions about your hypertension care. Active involvement in your own care is critical. You can and should be involved in decisions about your treatment.
Your Hypertension Team
Management of hypertension is a collaborative team effort. Your doctor will diagnose whether you have hypertension, prescribe medications and help you manage your medical conditions. Other professionals or programs that may help you successfully manage your hypertension may include:
- Nurse
- Nutritionist
- Pharmacist
- Weight loss program
- Stop smoking program
- Cardiologist (heart specialist) in cases of extremely high blood pressure, or when
a person has other serious heart problems
- Nephrologist (kidney specialist) in cases where a person also has kidney disease
Remember that you are the key player on this team and your daily management of your condition is vital to ensuring you get the best possible care.
PDF
Format
Some documents on this Web
site are in PDF format and require a PDF reader. If you do not have Adobe Acrobat
Reader Version 5.0 or higher or the most recent version of another PDF reader,
you can download Adobe Acrobat Reader by selecting the 'Get Acrobat Reader'
icon. 
Last Revised: February 14, 2007
| 
