High blood pressure diagnosis

High blood pressure can be diagnosed with a routine blood pressure test²⁸. This test is painless and noninvasive and can be performed by your healthcare provider as part of a routine checkup.

When measuring your blood pressure, your healthcare provider or specialist will place an inflatable cuff around your arm. This cuff inflates and deflates while measuring your blood pressure using a pressure-measuring gauge.

Blood pressure readings are reported in millimeters of mercury (mm Hg) and include two numbers. The first (upper) number measures the pressure in your arteries when your heart beats. This is called systolic pressure. The second (lower) number measures the pressure in your arteries between heart beats, which is called diastolic pressure.

Your blood pressure reading is expressed as the systolic pressure over the diastolic pressure. For example, if your measurement reads 120 systolic and 80 diastolic, you would say, “120 over 80,” or write “120/80 mmHg.”

The CDC classifies blood pressure readings in the following way:

• Normal blood pressure: Less than 120/80 mmHG
• At risk for high blood pressure (prehypertension): Between 120/80 mmHG and 13/89 mmHg
• High blood pressure (hypertension): More than 140/90 mmHG

Your target blood pressure range can vary depending on any pre-existing conditions you may have. For example, the recommended blood pressure for people with diabetes is below 130/80 mmHg.

If the cause of your high blood pressure isn’t clear, your doctor may order further testing. These can help find the underlying condition that’s raising your blood pressure and inform the course of treatment your doctor recommends.

Supplemental tests may include:

• Aldosterone test: Aldosterone (ALD) tests²⁹ measure your level of the hormone aldosterone, which regulates blood pressure and the amount of sodium and potassium in your blood. A result that shows an abnormally high level of aldosterone (hyperaldosteronism) may explain why you have high blood pressure.

• Chloride blood test: A chloride blood test³⁰ is part of a group of blood tests that measure the level of electrolytes in your blood. A high result on a chloride blood test may suggest that your high blood pressure stems from an underlying kidney issue. While many pharmacies offer free blood pressure testing stations, it’s often better to have your healthcare provider perform the test and go over the results with you. He or she can answer any questions you may have.

It’s also worth noting that some patients may receive falsely elevated blood pressure readings at a healthcare provider’s office but have normal blood pressure readings at home. This is known as “white coat hypertension³¹.”

Pulmonary hypertension diagnosis

Pulmonary hypertension is difficult to diagnose early, as it is not often detected in a routine physical exam. Even in its more advanced stages, pulmonary hypertension’s signs and symptoms are similar to those of a number of other heart and lung conditions.

If your healthcare provider believes you may be suffering from pulmonary hypertension, he or she will review your medical and family history, discuss your signs and symptoms, and conduct a physical examination. He or she may order additional tests such as imaging scans, that provide a clear view of your heart.

Some tests for pulmonary hypertension³² include:

• Echocardiogram: This test uses ultrasound (high-frequency sound waves) to create a moving picture of the beating heart. An echocardiogram³³ can help your provider check the size and functioning of the right ventricle, the thickness of the right ventricle’s wall, and the functioning of your heart chambers and valves. This test may also be used to measure the pressure in the pulmonary arteries.

• Chest X-ray: A chest x-ray³⁴ uses x-ray imaging to locate and create a picture of the heart, lungs, and other organs in the chest. This test can show enlargement of the right ventricle of the heart or the pulmonary arteries, both of which can occur with pulmonary hypertension. Chest X-rays can also be used to identify other conditions that may cause pulmonary hypertension.

• Electrocardiogram: An electrocardiogram³⁵ (ECG or EKG) is a noninvasive test that measures the electrical activity, rate, and regularity of your heartbeat. This test may also show signs of enlargement or strain in the right ventricle.

• Right heart catheterization: If your provider thinks you have pulmonary hypertension, you’ll likely have a right heart catheterization³⁶ after having an echocardiogram. This test can help confirm that you have pulmonary hypertension as well as determine the severity of your condition. During this procedure, a cardiologist (heart specialist) places a thin, flexible tube (called a catheter) into a vein in your neck or groin which is then threaded into your right ventricle and pulmonary artery. This test allows direct measurement of the pressure in the main pulmonary arteries and right ventricle and can be used to see what effect different medications might have on your pulmonary hypertension.

• Blood tests: Blood tests may be used to check for the presence of certain substances in your blood that may indicate that you have pulmonary hypertension or complications associated with the condition. Blood tests can also detect the presence of certain conditions that may be causing your pulmonary hypertension.
• Genetic testing: If one or more of your family members has had pulmonary hypertension, your provider may screen you for the presence of genes linked with pulmonary hypertension. If you test positive for these genes, he or she may recommend that other family members be screened for the same genetic mutations.

As with any condition, it is important that you see a provider if you have any new or worsened symptoms, or if you have a history of cardiovascular disease. He or she will be able to diagnose and properly treat any conditions you may have.