Diagnosing high blood pressure
The diagnosis for high blood pressure is fairly simple and painless. As previously mentioned, to measure blood pressure, a doctor or nurse wraps a sphygmomanometer (blood pressure cuff) around the upper arm and pumps it with air, so the instrument can cut off the circulation in your artery. Then, with the use of a stethoscope, the doctor or nurse gradually lets air out of the cuff in order to listen to and accurately measure the level of your blood pressure when it is being pumped (systolic pressure) and when the beating stops (diastolic pressure).
Since blood pressure levels and measurements can change quickly and vary in degree, a doctor may decide to take a patient’s blood pressure more than once. This may involve taking measurements while the person is both standing and sitting down or at different points in the week, since blood pressure may be high on one day and more normalized on another. Factors that contribute to these fluctuations include stress, worry, and the kind of usual nervousness that can arise during a doctor’s visit (which is also referred to as “white coat hypertension“). This broad-based approach enables doctors to more accurately determine whether a person actually suffers from high blood pressure.
The two numbers that are measured — the systolic and diastolic pressures — can vary greatly depending on the health and background of the patient. For example, a reading below 120/80 is considered average or normal for most adults. Doctors also consider blood pressure readings like 110/70 to be “low” and, therefore, safe and acceptable. However, doctors identify someone as having “high blood pressure” when his or her systolic pressure (top number) is at 140 or higher or when his or her diastolic pressure (bottom number) is at 90 or above. For instance, people with blood pressure readings of 110/90, 140/70, and 150/90 all have high blood pressure. In these cases, patients are usually prescribed some combination of treatment, often involving a healthier diet, physical exercise, and/or medication.
People who have a systolic pressure of 120-139 or diastolic pressure of 80-90 have a condition known as prehypertension that affects 46 million Americans. People who are diagnosed with prehypertension are at high risk for developing high blood pressure later on, but making healthy lifestyle changes now can help prevent that from happening. People with prehypertension should have their blood pressure monitored regularly.
As shown in the chart below, high blood pressure is also commonly diagnosed and classified at different levels.
Diagnosing high blood pressure levels
American Heart Association recommended blood pressure levels
| Blood Pressure Category | Systolic (top number) (mmHg) | Diastolic (bottom number) (mmHg) | |
| Normal | less than 120 | and | less than 80 |
| Prehypertension | 120-139 | or | 80-89 |
| High | |||
| Stage 1 | 140-159 | or | 90-99 |
| Stage 2 | 160 or higher | or | 100 or higher |
mmHg = millimeters of mercury
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