Exam Overview

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:

• Confirm that you 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 hypertension), such as medicines or other medical conditions.

Results

Blood pressure measurements are classified as follows.

Normal (optimal)

• 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

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: