Diagnosing high blood pressure

Measuring blood pressure

Having healthy blood pressure levels is vitally important for our continuing good health. As there is no way to know how high or low your blood pressure is, it’s important to have this checked on a regular basis – more often if you have a family history of high blood pressure, or a condition which can cause raised blood pressure.

A nurse or doctor at your GP’s surgery will take your blood pressure using an electronic blood pressure measuring device known as a sphygmomanometer. (These have largely taken over from the manually operated mercury versions used in the past.)*

How to monitor your blood pressure

If you have blood pressure readings of between 120/80mmHg or 140/90mm Hg or greater, your blood pressure could do with being reduced. Ideally, your blood pressure should be at most 120/80mmg at most, or 150/90mmHG or slightly greater if you are over 80 years old.

Making changes to your diet – less salt, more fruit and vegetables, less alcohol, watching your weight and more exercise, can all help to bring your blood pressure down. Instead switch over to a diet that includes food that is higher in fibre. Choose wholemeal versions of pasta and bread, wholegrain rice, and a wide range of fruit and vegetables.

However, if you have diabetes – related kidney problems, or long-term kidney disease or heart problems, your medical team may suggest that you have treatment for high blood pressure.

Blood pressure and kidney disease

Diabetes and blood pressure

If you have blood pressure of 140/90 Hg or more, when your blood pressure is taken over a few weeks, your doctor is very likely to suggest you have treatment to reduce it. This is especially so if you have diabetes, cardiovascular problems or other risk factors that mean you are likely to develop cardiovascular health issues.

If your blood pressure is steadily 160/100mm Hg or higher, your doctor likely to say that you should start having treatment for it straight away.

Tests for high blood pressure

By showing your doctor what is going on inside your body, simple blood tests can be very helpful, and involve the minimum of disruption, and often, the minimum amount of stress too. For most of the blood tests that need to be carried out, your doctor is likely to need a test tube of your blood. The doctor or nurse may take this during a normal visit, or you may need to go to the nearest phlebotomy clinic to have your blood collected. (Check with your doctor.)

Your blood will then be used to check whether you have a range of conditions, such as high cholesterol levels, kidney problems and diabetes. Your blood sample will also be able to show your medical team which medicines are likely to work best for you.

If your doctor just needs to check your blood sugar level, to see if you have diabetes, they just need to prick the tip of one of your fingers and put some of the blood on a test strip.

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The information provided by these blood tests can help your doctor decide on the best treatment for your particular condition.

Electrocardiogram (EKG or ECG)

Your doctor may suggest that you have an electrocardiogram (ECG or EKG), if they are concerned about your heart rate, rhythm, or the electrical activity in your heart. So, if you feel especially short of breath if you do fairly light exercise, or have quite high blood pressure, or an irregular heartbeat, your doctors may suggest having this test to find out what is going on in your heart.

Having an ECG involves having some electrodes attached to your body. These allow doctors to record what’s going on, and to check your heart’s electrical activity. Having an ECG gives your doctors a range of information on your heart’s activity. This can include finding out if enough blood is reaching all areas of your heart, if you have an irregular heartbeat (an arrhythmia), and if the electrical activity is functioning properly. (This procedure is painless.)

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Echocardiogram

An echocardiogram (also known as an echo) makes images of your heart using sound waves. These images show your doctor if your heart is working normally, and whether there are any problems in any areas of your heart. It is a very useful and painless way of checking for abnormalities, such as valves or other parts of your heart that are enlarged, or aren’t working properly. Echocardiograms can also be used to check on the causes of a heart attack, and other existing problems. They are regarded as being of great value in diagnosing health problems such as high blood pressure and heart failure.

When you have an echocardiogram, you’ll need to take off your clothes above the waist – you should be offered a gown to cover up with. Then when you’re lying down, you’ll have a few small electrodes gently stuck to your chest. These are to check the rhythm of your heart throughout the test.

Once some lubricating gel has been rubbed onto your chest (and/or the probe), you’ll be positioned lying on your left-hand side, and your doctor will move the probe across your chest.

When this is happening the probe sends out high frequency sound waves that travel through your skin to your heart, and send ultrasound waves back out. The probe registers these ‘echos’ and sends them back to the echocardiogram. They appear on the machine’s screen as images of your heart.

In some cases, if your doctor wants to find out more information about your heart than the echo is providing, they may carry out another procedure. This involves having a small probe passed down your throat until it is behind your heart. This can provide more valuable information about this part of your heart. You are likely to be given a sedative before this procedure is carried out.

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X-ray

Your doctor may suggest that you have a chest X-ray if you are struggling with shortness of breath. The X-ray should be able to show if you have problems that could be causing shortness of breath, such as scarring in your lungs, or an enlarged heart.

X-rays are also used to help diagnose pulmonary hypertension. This is when your heart pumps oxygenated blood from your heart to your lungs. If the arteries in your lungs thicken and become narrower, it is harder for the blood to pass through them, which means that the blood pressure in these arteries increases. Chest X-rays are one of a number of tests used to check whether you have this condition.

Saga Health Insurance offers a range of health plans which provide cover if you develop high blood pressure (hypertension). If you've already been diagnosed they can often still cover your hypertension anyway, subject to some simple health questions and an additional premium. Find out more.

Doppler ultrasound

Doppler ultrasound scans use high-frequency sound waves to make accurate recreations of your internal organs on a monitor or screen. This allows your doctors to see images of your heart, liver, arteries and veins. They are also used during biopsies (of breast lumps for example) and to scan the development of unborn babies in the womb.

These scans use high-frequency sound, which sends back echoes when it comes into contact with a fairly solid surface. The echoes create an image of the artery, heart or other organ, which appears on a screen.

Doppler ultrasound is also used to check on the amount of blood flowing through your arteries to your kidneys. This can show narrow points in your arteries, possibly caused by plaques – deposits of fibrous material and fats that may go on to cause high blood pressure in some patients.

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