Blood pressure readings vary greatly in individuals depending on the time of day, where the patient is at when they get it checked, how soon they have eaten, smoked, or even drank a cup of coffee. A diagnosis of hypertension should not be based on one reading unless that reading is extremely high and/or there is evidence of end organ damage such as renal (kidney) or heart involvement. The diagnosis of hypertension should be made only after two or more readings on two or more office visits.

If you are being diagnosed with hypertension for the first time, there are certain tests that your doctor should order. Blood tests including a complete blood count, fasting lipids (cholesterol), fasting blood sugar, renal (kidney) functions, liver functions, and electrolytes (potassium, sodium levels), along with a urinalysis should be checked. You should also have a chest xray to check for enlargement of your heart which can occur over time with hypertension, and an electrocardiogram to check for any cardiac (heart) abnormalities.

If your blood pressure is not extremely elevated, say in the 145/95 range, and you are determined to make substantial lifestyle changes, then perhaps you can bring your blood pressure down to normal range with these measures. I always give my patients in these situations the option to try lifestyle modifications first if they wish as long as their blood pressure is not seriously high. Most patients, however, end up having to take a medication for their hypertension.

Don’t be afraid to talk to your doctor about treatment and asking about the tests I have discussed. Most importantly, please get into your physician at least once a year to get your blood pressure taken, and more often if it has been on the high end of normal.