A physical exam for high blood pressure also includes a medical history. The extent of the physical exam and the level of detail in your doctor's questions depend on how high your blood pressure is and whether you have other risk factors for heart disease. People who have many risk factors may have a more detailed evaluation.
The physical exam and medical history includes:
Your medical history, to evaluate risk factors such as smoking or family history of high blood pressure.
Two or more blood pressure measurements. Measurements may be taken from both the left and right arms and legs and may be taken in more than one position, such as lying down, standing, or sitting. Multiple measurements may be taken and averaged.
Measurement of your weight, height, and waist.
An exam of the retina, the light-sensitive lining at the back of the eye.
A heart exam.
An exam of your legs for fluid buildup (edema), and the pulse in several areas, including the neck.
An exam of your abdomen using a stethoscope. A doctor will listen to the blood vessels in the abdomen for abnormal sounds. These sounds may be caused by blood flow through a narrowed artery in the abdomen (abdominal bruits).
An exam of your neck for an enlarged thyroid, distended neck veins, and bruits in the carotid arteries.
Why It Is Done
The physical exam and medical history are done to:
Check to see if you might have high blood pressure.
Check for effects of high blood pressure on organs such as the kidneys and heart.
Determine whether you have risk factors for heart disease or stroke.
Rule out other causes of high blood pressure (secondary high blood pressure), such as medicines or other medical conditions.
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, footnote 1 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.
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.
Hypertension, or high blood pressure, is a condition where the pressure of blood against the walls of vessels is persistently elevated. A blood pressure close to 120/90 is considered normal and is considered high when it crosses 140/90. There are millions of cases of hypertension reported every year and it can last for years or can even be life-long. What makes hypertension a serious condition is that it often has no symptoms, and if left untreated over a long period of time, it may lead to serious health conditions like heart disease and strokes. Hypertension patients have to take special care of their daily meals and follow a strict high blood pressure diet to manage symptoms of the condition. This season demands that BP patients include healthy summer drinks in their diet.
Adding certain foods and drinks to your daily diet may help regulate symptoms of hypertension. Ideally, high blood pressure patients should eat foods that are low in sodium and saturated fat content and rich in fibre. Eating low-calorie and low-fat nutrient-rich foods and drinks may work wonders for hypertension patients, and during summers, one such BP-friendly drink is coconut water.
Hypertension Diet: Coconut Water For High BP
Coconut water is one of the healthiest summer drinks out there. The translucent liquid that is collected inside a green coconut is widely consumed as a thirst-quencher around the world. However, drinking it daily may have special benefits for hypertension patients. Here's why:
1. Low In Calories
A 100 ml of coconut water contains just 19 calories (according to the United States Department of Agriculture) and no fat or cholesterol.
2. Rich In Potassium
One of the most important minerals for hypertension patients who normally consume salty diet is potassium, which balances out the negative effects of salt. Coconut water contains 250 mg of potassium per 100 ml.
3. Reduces Blood Cholesterol
Blood cholesterol and high blood pressure are linked, as the hardening of arteries can put a strain on the heart by pushing it harder to pump blood. This raises the BP. Coconut water is said to reduce levels of triglycerides and blood cholesterol, thus helping hypertension patients.
A number of studies conducted on the health benefits of coconut water have proven that the drink is not just deliciously hydrating and filled with electrolytes, but may also be quite healthy for high blood pressure patients. Adding chilled coconut water to your hypertension diet this summer may help you improve your BP readings.
Walnuts are said to be healthy for daily consumption. The nuts are said to be loaded with healthy fats in the form of omega 3 fatty acids as well as fibre. A new study has said that consuming walnuts can be particularly beneficial for those suffering from metabolic syndrome and may potentially bring down the risk of developing diabetes in such people. This is because walnuts may increase the levels of good cholesterol or High-Density Lipoprotein (HDL) in the body and may even decrease fasting glucose level. Diabetes is a condition where the levels of blood glucose are persistently elevated. People suffering from metabolic syndrome have an elevate risk of developing Type-2 diabetes, stroke and heart diseases. This study's results may lead to a potential novel dietary method for bringing down risk of diabetes in metabolic syndrome patients.
The results of the study were published in the journal Nutrition Research and Practice. For the study, researchers divided 119 Korean males and females with metabolic syndrome into two separate control groups randomly. While the first group was asked to consume 45 gm of walnuts everyday for 16 weeks, the second group was asked to consume iso-caloric white bread as snacks. Both the groups had a six-week rest period, at the end of the 16 weeks, after which walnuts and white bread were cross-overly distributed to the two groups for a period of 16 weeks again. During the trial, the lipid profile, Hb1Ac levels, levels of adiponectin as well as leptin, apolipoprotein B were measured four times along with anthropometric and bioimpedance data.
Five markers of metabolic syndromes- blood sugar, blood pressure, cholesterol levels, triglycerides and abdominal fat- were also mapped. It was reported that a little over half (51.2 per cent) of the participants with metabolic syndrome at baseline had reverted to normal status after 16 weeks of consuming walnuts. The levels of HDL, fasting glucose, Hb1Ac and adiponectin were observed to have improved significantly. The researchers concluded that consuming walnuts are snacking alternatives for high-carbohydrate foods may be a good idea for improvement in patients of metabolic syndrome.
High blood pressure is a common condition in which the long-term force of the blood against your artery walls is high enough that it may eventually cause health problems, such as heart disease.
Blood pressure is determined both by the amount of blood your heart pumps and the amount of resistance to blood flow in your arteries. The more blood your heart pumps and the narrower your arteries, the higher your blood pressure.
You can have high blood pressure (hypertension) for years without any symptoms. Even without symptoms, damage to blood vessels and your heart continues and can be detected. Uncontrolled high blood pressure increases your risk of serious health problems, including heart attack and stroke.
High blood pressure generally develops over many years, and it affects nearly everyone eventually. Fortunately, high blood pressure can be easily detected. And once you know you have high blood pressure, you can work with your doctor to control it.
Most people with high blood pressure have no signs or symptoms, even if blood pressure readings reach dangerously high levels.
A few people with high blood pressure may have headaches, shortness of breath or nosebleeds, but these signs and symptoms aren't specific and usually don't occur until high blood pressure has reached a severe or life-threatening stage.
When to see a doctor
You'll likely have your blood pressure taken as part of a routine doctor's appointment.
Ask your doctor for a blood pressure reading at least every two years starting at age 18. If you're age 40 or older, or you're 18 to 39 with a high risk of high blood pressure, ask your doctor for a blood pressure reading every year.
Blood pressure generally should be checked in both arms to determine if there's a difference. It's important to use an appropriate-sized arm cuff.
Your doctor will likely recommend more frequent readings if you've already been diagnosed with high blood pressure or have other risk factors for cardiovascular disease. Children age 3 and older will usually have blood pressure measured as a part of their yearly checkups.
If you don't regularly see your doctor, you may be able to get a free blood pressure screening at a health resource fair or other locations in your community. You can also find machines in some stores that will measure your blood pressure for free.
Public blood pressure machines, such as those found in pharmacies, may provide helpful information about your blood pressure, but they may have some limitations. The accuracy of these machines depends on several factors, such as a correct cuff size and proper use of the machines. Ask your doctor for advice on using public blood pressure machines.
There are two types of high blood pressure.
Primary (essential) hypertension
For most adults, there's no identifiable cause of high blood pressure. This type of high blood pressure, called primary (essential) hypertension, tends to develop gradually over many years.
Some people have high blood pressure caused by an underlying condition. This type of high blood pressure, called secondary hypertension, tends to appear suddenly and cause higher blood pressure than does primary hypertension. Various conditions and medications can lead to secondary hypertension, including:
Obstructive sleep apnea
Adrenal gland tumors
Certain defects you're born with (congenital) in blood vessels
Certain medications, such as birth control pills, cold remedies, decongestants, over-the-counter pain relievers and some prescription drugs
Illegal drugs, such as cocaine and amphetamines
High blood pressure has many risk factors, including:
Age. The risk of high blood pressure increases as you age. Until about age 64, high blood pressure is more common in men. Women are more likely to develop high blood pressure after age 65.
Race. High blood pressure is particularly common among people of African heritage, often developing at an earlier age than it does in whites. Serious complications, such as stroke, heart attack and kidney failure, also are more common in people of African heritage.
Family history. High blood pressure tends to run in families.
Being overweight or obese. The more you weigh the more blood you need to supply oxygen and nutrients to your tissues. As the volume of blood circulated through your blood vessels increases, so does the pressure on your artery walls.
Not being physically active. People who are inactive tend to have higher heart rates. The higher your heart rate, the harder your heart must work with each contraction and the stronger the force on your arteries. Lack of physical activity also increases the risk of being overweight.
Using tobacco. Not only does smoking or chewing tobacco immediately raise your blood pressure temporarily, but the chemicals in tobacco can damage the lining of your artery walls. This can cause your arteries to narrow and increase your risk of heart disease. Secondhand smoke also can increase your heart disease risk.
Too much salt (sodium) in your diet. Too much sodium in your diet can cause your body to retain fluid, which increases blood pressure.
Too little potassium in your diet. Potassium helps balance the amount of sodium in your cells. If you don't get enough potassium in your diet or retain enough potassium, you may accumulate too much sodium in your blood.
Drinking too much alcohol. Over time, heavy drinking can damage your heart. Having more than one drink a day for women and more than two drinks a day for men may affect your blood pressure.
If you drink alcohol, do so in moderation. For healthy adults, that means up to one drink a day for women and two drinks a day for men. One drink equals 12 ounces of beer, 5 ounces of wine or 1.5 ounces of 80-proof liquor.
Stress. High levels of stress can lead to a temporary increase in blood pressure. If you try to relax by eating more, using tobacco or drinking alcohol, you may only increase problems with high blood pressure.
Certain chronic conditions. Certain chronic conditions also may increase your risk of high blood pressure, such as kidney disease, diabetes and sleep apnea.
Sometimes pregnancy contributes to high blood pressure, as well.
Although high blood pressure is most common in adults, children may be at risk, too. For some children, high blood pressure is caused by problems with the kidneys or heart. But for a growing number of kids, poor lifestyle habits, such as an unhealthy diet, obesity and lack of exercise, contribute to high blood pressure.
The excessive pressure on your artery walls caused by high blood pressure can damage your blood vessels, as well as organs in your body. The higher your blood pressure and the longer it goes uncontrolled, the greater the damage.
Uncontrolled high blood pressure can lead to complications including:
Heart attack or stroke. High blood pressure can cause hardening and thickening of the arteries (atherosclerosis), which can lead to a heart attack, stroke or other complications.
Aneurysm. Increased blood pressure can cause your blood vessels to weaken and bulge, forming an aneurysm. If an aneurysm ruptures, it can be life-threatening.
Heart failure. To pump blood against the higher pressure in your vessels, the heart has to work harder. This causes the walls of the heart's pumping chamber to thicken (left ventricular hypertrophy). Eventually, the thickened muscle may have a hard time pumping enough blood to meet your body's needs, which can lead to heart failure.
Weakened and narrowed blood vessels in your kidneys. This can prevent these organs from functioning normally.
Thickened, narrowed or torn blood vessels in the eyes. This can result in vision loss.
Metabolic syndrome. This syndrome is a cluster of disorders of your body's metabolism, including increased waist circumference; high triglycerides; low high-density lipoprotein (HDL) cholesterol, the "good" cholesterol; high blood pressure and high insulin levels. These conditions make you more likely to develop diabetes, heart disease and stroke.
Trouble with memory or understanding. Uncontrolled high blood pressure may also affect your ability to think, remember and learn. Trouble with memory or understanding concepts is more common in people with high blood pressure.
Dementia. Narrowed or blocked arteries can limit blood flow to the brain, leading to a certain type of dementia (vascular dementia). A stroke that interrupts blood flow to the brain also can cause vascular dementia.