Evaluation of Blood Pressure

Evaluation of patients with high blood pressure consists primarily of the following:

  • Focused history to collect important data including symptoms like chest pain
  • Family history of high blood pressure
  • Medical history of co-existing conditions like diabetes
  • Physical examination
  • Blood tests
  • Electrocardiogram
  • Echocardiogram or ultrasound of the heart

The doctor or nurse will ask the patient if he or she has ever been told they have high blood pressure; if high blood pressure runs in their family; what medications they are taking (certain prescription drugs and over-the-counter medicines can cause hypertension); if they have experienced symptoms such as sweating, palpitations, headaches, dizziness, or weight loss (which can suggest a glandular cause or, rarely, a tumor); and if there are other medical conditions.

During the physical examination, the doctor usually checks the blood pressure in both arms (rare conditions produce different blood pressures in each arm); feels the thyroid gland in the neck to see if it is enlarged or nodular; listens to the heart for "extra" heart sounds; and listens over the neck, abdomen, and groin area for sounds created by turbulent blood flow through diseased or blocked arteries. The health care specialist may also take a careful look at the back of the eyes with an ophthalmoscope, examining the small blood vessels for signs of damage from chronic high blood pressure.

Several blood tests are usually performed to check for evidence of kidney dysfunction, which can cause high blood pressure, and abnormal mineral levels, which may suggest glandular problems. An electrocardiogram (ECG) is often obtained to determine whether the heart walls or chambers are thickening or becoming enlarged as a result of chronic, untreated hypertension, or whether a person has previously suffered a heart attack (myocardial infarction).

Publication Review By: Jagdish Patel, M.D., F.A.C.C.

Published: 01 Jul 2000

Last Modified: 13 Jul 2013