Cardiovascular Disease High Blood Pressure Common Diseases

Making the Diagnosis of Hypertension: A Synopsis for Non-Medical Folks

This entry is part 5 of 6 in the series A Simplified Guide to Hypertension

Hypertension is like a sneaky ninja; it lurks in our bodies for years, often without showing any signs. However, it’s vital to catch it early to prevent heart and kidney problems down the line. So, how do doctors diagnose hypertension or high blood pressure? 

Imagine your heart is a pump and your blood vessels are the pipes it uses to deliver blood to the entire body. If these pipes are narrow or stiff, resistance can increase along with pressure—just like when you try to force too much water through a small garden hose.

When diagnosing hypertension, doctors don’t rely on just one blood pressure reading. They take multiple readings over time, sometimes in different settings outside the doctor’s office. It’s a bit like getting a second, third, or even fourth opinion before jumping to a conclusion.

There’s a bit of disagreement in the medical community about the specific blood pressure number that should be considered “high.” Yet, generally, when your average blood pressure readings at home exceed 130 over 80, or if it’s even higher when measured at a doctor’s office, you might be diagnosed with hypertension. 

In some extreme cases, if your blood pressure is dangerously high (think: 180 over 120) or if it’s quite high alongside evidence of damage to your heart or other organs, doctors may diagnose hypertension without any extra confirmatory tests. It’s kind of like if your car is smoking and making a terrible noise, you don’t need a mechanic to tell you something’s wrong.

However, sometimes, people get anxious (“white coat syndrome”) in clinical settings, which can temporarily raise blood pressure. In that case, doctors may suggest “out-of-office” readings via home monitoring or ambulatory blood pressure monitoring (a device you wear that measures your blood pressure throughout the day). It’s like trying to catch the ninja in action when it thinks no one is watching!

If your blood pressure is high at the doctor’s office but normal at home, you might have what’s called “white coat hypertension.” It’s important to check your blood pressure outside the doctor’s office regularly as white coat hypertension can turn into actual hypertension over time.

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