Elevated Blood Pressure

Diagnosis

Elevated blood pressure is diagnosed with a blood pressure test, which measures the pressure of blood flow in your arteries. This test is usually done as part of a routine health checkup or during a screening for high blood pressure.

Blood pressure readings are recorded in millimeters of mercury (mm Hg) and include two numbers:

• The systolic (top) number measures the pressure when the heart contracts and pumps blood.

• The diastolic (bottom) number measures the pressure when the heart relaxes between beats.

A reading between 120–129 mm Hg systolic and less than 80 mm Hg diastolic is considered elevated blood pressure.

Diagnosis is confirmed based on the average of two or more readings taken on different occasions. During the first measurement, both arms should be tested. Future readings should be taken from the arm with the higher measurement.

Sometimes, ambulatory blood pressure monitoring is recommended, which records blood pressure at regular intervals over 6 to 24 hours. Your provider may also ask you to monitor your blood pressure at home using an automated device.

Additional tests may include:

• Complete blood count (CBC)

• Cholesterol test (lipid profile)

• Blood sugar (glucose) test

• Kidney and thyroid function tests

• Electrocardiogram (ECG or EKG) to check heart rhythm and detect related heart conditions

Treatment

Treatment for elevated blood pressure focuses on healthy lifestyle changes. If you also have conditions like diabetes, kidney disease, or heart disease, medication may be recommended.

Those with stage 1 or stage 2 hypertension usually need a combination of blood pressure medicine and lifestyle modifications.

Key self-care and lifestyle tips:

• Eat a heart-healthy diet: Follow the DASH diet, which includes fruits, vegetables, whole grains, fish, poultry, and low-fat dairy. Reduce intake of saturated and trans fats, and increase potassium-rich foods.

• Use less salt (sodium): Check food labels and limit sodium intake by at least 1,000 mg a day. Ideally, aim for 1,500 mg or less daily.

• Maintain a healthy weight: Losing even a small amount of weight can help lower blood pressure. On average, blood pressure drops about 1 mm Hg for every kilogram (2.2 pounds) lost.

• Be physically active: Engage in at least 150 minutes of moderate or 75 minutes of vigorous aerobic activity per week.

• Limit alcohol: Up to one drink a day for women and two for men is generally acceptable.

• Quit smoking: Tobacco damages blood vessels and accelerates heart disease.

• Manage stress: Use relaxation techniques such as meditation, exercise, or mindfulness to reduce stress levels.

Preparing for Your Appointment

If you suspect elevated blood pressure, schedule an appointment with your healthcare provider.

Before your visit:

• Avoid caffeine, exercise, and tobacco for at least 30 minutes before testing.

• Bring a list of all medications, vitamins, and supplements you take.

• Don’t stop taking prescribed medication without consulting your healthcare provider.

You should also prepare:

• A list of symptoms, even if minor.

• Any family history of high blood pressure, heart disease, or diabetes.

• Questions to ask your doctor, such as:

  • What tests do I need?

  • Do I need medication?

  • How often should I check my blood pressure?

  • What lifestyle changes will help the most?

Your healthcare provider may also ask about your diet, exercise habits, alcohol use, and smoking history to better understand your overall heart health.