Physical Exam for High Blood Pressure

Results

Blood pressure measurements for adults are classified as follows.^{footnote 1}

Ideal blood pressure

• Systolic 119 millimeters of mercury (mm Hg) or below
• Diastolic 79 mm Hg or below

Prehypertension

• Systolic 120-139 mm Hg
• Diastolic 80-89 mm Hg

High blood pressure (hypertension)

• Systolic 140 mm Hg or above
• Diastolic 90 mm Hg or above

High blood pressure is also classified into stages.

• Stage 1 high blood pressure:
  • Systolic 140-159 mm Hg
  • Diastolic 90-99 mm Hg

• Stage 2 high blood pressure:
  • Systolic 160 mm Hg or higher
  • Diastolic 100 mm Hg or higher

Making sure that blood pressure is actually high

After measuring your blood pressure, your doctor may ask you to test it again when you are home.^{footnote 2} This is because your blood pressure can change throughout the day. And sometimes blood pressure is high only because you are seeing a doctor. This is called white-coat hypertension. To diagnose high blood pressure, your doctor needs to know if your blood pressure is high throughout the day.

So your doctor may ask you to monitor your blood pressure at home to make sure that it actually is high. You may get an ambulatory blood pressure monitor or a home blood pressure monitor. These devices measure your blood pressure several times throughout the day.

Other results

Your doctor might check for signs that high blood pressure has already caused damage to your blood vessels, heart, or eyes. Your doctor might check for:

• Extra heart sounds caused by enlargement of the heart.
• Swollen (distended) neck veins, which may point to possible heart failure.
• Abnormal sounds when the doctor listens to the blood vessels in the abdomen using a stethoscope. These sounds may be caused by blood flow through a narrowed artery in the abdomen (abdominal bruits) or a narrowed artery leading to the kidney (renal artery stenosis) or by abnormal movement of blood through the aorta, the main artery that carries blood from the heart to the rest of the body.
• Abnormal sound of blood flow (bruit) or diminished or absent blood flow (pulses) in the blood vessels of the arms and legs.
• Abnormal buildup of fluid in the abdomen or legs (edema).
• Abnormalities of the blood vessels in the back of the eye.