Hypertension Diagnosis

Blood pressure test is quick and easy, it measures pressure in millimeters of mercury (mmHg) and recorded as two numbers systolic over a diastolic, example, 120 over 80 or 120/80.

Blood pressure is a vital indicator of the overall health. To understand blood pressure diagnosis you require to know about:

• Systolic blood pressure – this is the blood pressure when the heart contracts (beats). It is the first or top number in the blood pressure measurement.
• Diastolic blood pressure – this is the blood pressure between heartbeats (when the heart rests or relaxes). It is the second or bottom number in the blood pressure measurement.

8 blood pressure categories in mmHg

1. Optimal BP – Below 120 (SBP) & 80 (DBP). The most favorable blood pressure range. This range is good for your heart, kidney, other internal organs, and for overall health. Recheck BP every year.
2. Normal BP – Below 130 (SBP) & 85 (DBP). Blood pressure range noted among most healthy individuals, even if it is not optimal. Recheck BP every year.
3. Prehypertension – Within 130 to 139 (SBP) & 85 to 89 (DBP). Prehypertension is an alarm that you may develop hypertension at any time. Recheck BP once in 3 to 6 months.
4. Grade 1 HTN – Within 140 to 159 (SBP) & 90 to 99 (DBP). Stage 1 hypertension individual needs lifestyle changes and may consider taking medication. Recheck BP once in 2 months & treat accordingly.
5. Grade 2 HTN – Within 160 to 179 (SBP) & 100 to 109 (DBP). Stage 2 hypertension individual may need to take combination hypertension medication. Recheck BP within one month & confirm treatment.
6. Grade 3 HTN – Above 180 (SBP) & 110 (SBP). Stage 3 hypertension individual require immediate emergency medical care. Recheck BP within one week, until BP drops.
7. Isolated systolic HTN (grade 1) – SBP within 140 to 159 & DBP below 90. Stage 1 isolated systolic hypertension individuals require a lifestyle change and drug. Care should be taken to avoid DBP less than 55 mm Hg in older patients with ISH. Recheck BP once in 2 months & treat accordingly.
8. Isolated systolic HTN (grade 2) – SBP above 160 & DBP below 90. Stage 1 isolated systolic hypertension individuals require a lifestyle change and drugs. Care should be taken to avoid DBP less than 55 mm Hg in older patients with ISH. Recheck BP within one month & confirm treatment.

How to you prepare yourself for hypertension diagnosis?

Blood pressure measurement can influence by numerous factors; thus, you should prepare yourself to avoid these negative influences.

• Coffee or smoking - Do not drink coffee or smoke cigarettes for 30 minutes before the test. Smoking and caffeine may cause a short-term rise in the blood pressure.
• Empty your bladder - Go to the bathroom, urinate to empty the bladder, a full bladder can show an elevated blood pressure reading.
• Sit comfortably - Sit in a comfortable position for 5 minutes before the test, movement can cause short-term rises in blood pressure.
• No tension/anxiety - Avoid tension-anxiety and make yourself-cool, anxiety may raise pressure.
• Rest before measurement - Do not perform any strong physical activity before blood pressure diagnosis.

Correct procedure for hypertension diagnosis
Blood pressure measurement is easy to take using sphygmomanometer or automatic blood pressure monitor; it takes just less than 5 minutes for a single reading.

How to take blood pressure measurement?

• BP on both arm - Blood pressure measurement varies from one arm to another; measure blood pressure in both arms and use the arm with higher reading for subsequent measurements.
• Relax - You should relax for at least 5 minutes in a proper sitting position before BP measurement.
• Support the arm - Rest your arm by supporting it at the level of the heart. Ensure no tight clothing that might constrict the arm.
• Proper cuff position - Neatly place the cuff with the indicator mark over the brachial artery. The bladder should cover at least 80 % of the arm (but not more than 100 % – that is bladder encircle over the bladder).
• Repeat three times - You should repeat blood pressure measurement three times and record measurement as displayed. Calculate an average value, which is your actual blood pressure number.

Both systolic blood pressure (SBP) and diastolic blood pressure (DBP) in a blood pressure reading are important.

At a younger age, DBP number is most useful, and when grows older, SBP is especially significant.

How do you avoid incorrect hypertension diagnosis?

Blood pressure can vary from time to time and affected by many factors, the food you ate, the level of physical activity, your mental state (stress, anxiety, etc.) and much more. Some of those factors that can affect your blood pressure and may contribute to incorrect blood pressure measurement are:

• Biorhythms or circadian rhythm in blood pressure - your body responded rhythmically on the regular cycles of day, afternoon, evening, night, sun, moon and seasons. Similarly, the highest BP reading occurs during late morning up to the middle of the afternoon. The lowest reading occurs during early sleep. Therefore, discuss with your physician regarding this biorhythm before you confirmed as high blood pressure.
• Only one blood pressure reading has no meaning - Blood pressure can be influenced by the time during the day. Some of the influencers are food you have recently eaten (particularly salty foods), your mental state (stress, anxiety, etc.), the level of recent physical activity, how well you sleep on previous night and temperature inside the room. Therefore, you must take two to three BP reading at different times during a day; calculate the average that is your blood pressure number.
• White coat syndrome - high BP reading in front of white-coated persons (doctors, nurses or other health-care professional) otherwise the blood pressure is normal.