Exams and Tests

The main test for high blood pressure is simple, fast, and painless. These are the usual steps:

1. You sit quietly for 5 minutes before the test, with both feet flat on the floor.
2. You sit down with your arm resting on the arm of the chair so that the arm is level with your heart.
3. An inflatable sleeve, called a cuff, is wrapped around your upper arm. It's attached to a dial that will show your blood pressure numbers.
4. The nurse (or other health professional) seals the cuff and pumps it up. You feel tight pressure as the cuff cuts off the blood flow in your arm.
5. Next, the nurse slowly loosens the cuff while using a stethoscope to listen to the heartbeat in your inner elbow. When the cuff is just loose enough that blood starts to flow again and the nurse can hear it, that is your systolic blood pressure.
6. The cuff is slowly loosened some more. When it's loose enough that your heartbeat can no longer be heard through the stethoscope, that is your diastolic blood pressure.

If this test shows that your blood pressure is high, your doctor will likely have you come in two more times to be tested. This will confirm that you have high blood pressure.

Some people only have high blood pressure when they're at the doctor's office. This is called white-coat hypertension. If your doctor thinks this is getting in the way of measuring your true blood pressure, you may need to get your blood pressure measured away from the doctor's office.

Regular blood pressure checks

All adults should have their blood pressure checked regularly. Experts recommend:²

• At least every 1 to 2 years if your blood pressure is normal (119/79 or lower).
• At least every year—or as often as your doctor recommends—if you have prehypertension. This means your systolic pressure (the first number) is 120 to 139 and your diastolic pressure (the second number) is 80 to 89.
• More often if you have other risk factors for heart disease or evidence of disease caused by high blood pressure.

The automated devices you find in grocery stores or drugstores may not be accurate. Having your blood pressure checked at the doctor's office is best.

A home blood pressure monitor makes it easy to keep track of your blood pressure. It's a good idea to bring your home monitor to the doctor's office to check its accuracy.

High Blood Pressure: Checking Your Blood Pressure at Home

Other tests

Besides taking your blood pressure, your doctor will do a physical exam and medical history. Your doctor may also have you get other tests to find out whether high blood pressure has damaged any organs or caused other problems. These tests may include:

• Urine tests to check for kidney or liver disease.
• Blood tests to check your levels of potassium, sodium, and cholesterol.
• A blood glucose test to check for diabetes.
• Tests to measure kidney function.
• An electrocardiogram (EKG, ECG) to find out whether there is any damage to the heart.

Your doctor may also check your risk of coronary artery disease.

Sometimes doctors automatically schedule routine tests because they think that's what patients expect. But experts say that routine heart tests can be a waste of time and money. For more information, see Heart Tests: When Do You Need Them?