CHAPTER 9

Diagnosing Pressure

PART 1 How Often Should You Have Your Blood Pressure Checked?

Have your blood pressure checked every 2 years after the age of 21, and more often if you have a family history of hypertension or other risk factors. If you do have high blood pressure, you will need to go on, and keep on, treatment, whether that treatment means changes in your lifestyle alone or includes medication as well. Don’t let hypertension be a “silent killer.”

PART 2 How High Blood Pressure Is Diagnosed

In a doctor or other healthcare practitioner’s office, blood pressure is usually measured with a device called a sphygmomanometer. This device consists of a stethoscope, arm cuff, pump, valve, and dial. (Devices with digital readouts are simpler to use and can be purchased for home use.) READ MORE

Blood pressure is measured after you sit or lie down for 5 minutes. One reading is not enough to make a diagnosis. If you have an initial high reading at a doctor’s office, your blood pressure will be measured again during the same visit and then measured twice on at least two other days to confirm that the hypertension persists.

If the high blood pressure proves to be persistent, you will be diagnosed with hypertension. The next step is to examine the organs that may have been affected by the condition, especially the heart, brain, kidneys, blood vessels, and eyes. The doctor will also try to determine the cause of the hypertension, though a specific cause is detected in fewer than 10% of all cases. LESS

PART 3 What Those Blood Pressure Numbers Mean

Blood pressure is usually stated as two numbers that represent the highest and lowest pressure your heart attains during a single beat. The first or top number represents the pressure when your heart contracts: the systolic pressure. The second or bottom number represents the pressure when your heart rests between beats: the diastolic pressure. You’ll often see “mm Hg” written after the numbers. This means “millimeters of mercury,” the units used to measure blood pressure. READ MORE

According to the National Institutes of Health, these are the categories for blood pressure levels in adults (measured in mm Hg):

Category	Systolic (top number)		Diastolic (bottom number)
Normal	Less than 120	and	Less than 80
Prehypertension	120–139	or	80–89
High blood pressure
Stage 1	140–159	or	90–99
Stage 2	160 or higher	or	100 or higher

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PART 4 Hypertensive Emergency

A hypertensive emergency exists when blood pressure reaches levels that damage your organs. This usually happens at blood pressure levels exceeding 180 systolic or 120 diastolic, but it can occur at even lower levels in people whose blood pressure had not been previously high. READ MORE

Uncontrolled blood pressure in this range can cause

Stroke

Loss of consciousness

Memory loss

Heart attack

Damage to the eyes and kidneys

Loss of kidney function

Aortic dissection (tearing of the aortic wall)

Angina (chest pain)

Pulmonary edema (fluid backup in the lungs)

Eclampsia (convulsions and coma in a pregnant woman)

If you have a blood pressure reading of 180 or higher systolic or 120 or higher diastolic, and have any symptoms of organ damage (chest pain, shortness of breath, back pain, numbness/weakness, change in vision, difficulty speaking), take action immediately. Access emergency medical services (EMS) or have someone drive you to the hospital right away. LESS