Diagnosing Hypertension in an individual needs meticulous BP measurements.
1.If blood pressure measured in the clinic is 140/90 mmHg or higher:
Take a second measurement during the consultation.
If the second measurement is substantially different from the first, take a third measurement.
Record the lower of the last 2 measurements as the clinic blood pressure.
2.If clinic blood pressure is between 140/90 mmHg and 180/120 mmHg, offer ambulatory blood pressure monitoring (ABPM) to confirm the diagnosis of hypertension.
3.f ABPM is unsuitable or the person is unable to tolerate it, offer home blood pressure monitoring (HBPM) to confirm the diagnosis of hypertension.
4.While waiting for confirmation of a diagnosis of hypertension, carry out:
One needs to investigate for the target organs like Heart , Kidney and Brain circulation.
formal assessment of cardiovascular risk using a cardiovascular risk assessment tool.
When using ABPM to confirm a diagnosis of hypertension, ensure that at least 2 measurements per hour are taken during the person’s usual waking hours (for example, between 08:00 and 22:00). Use the average value of at least 14 measurements taken during the person’s usual waking hours to confirm a diagnosis of hypertension. [2011]
7When using HBPM to confirm a diagnosis of hypertension, ensure that:
for each blood pressure recording, 2 consecutive measurements are taken, at least 1 minute apart and with the person seated and
blood pressure is recorded twice daily, ideally in the morning and evening and
blood pressure recording continues for at least 4 days, ideally for 7 days.
Discard the measurements taken on the first day and use the average value of all the remaining measurements to confirm a diagnosis of hypertension.
Confirm diagnosis of hypertension in people with a:
clinic blood pressure of 140/90 mmHg or higher and
ABPM daytime average or HBPM average of 135/85 mmHg or higher.
If hypertension is not diagnosed but there is evidence of target organ damage, consider carrying out investigations for alternative causes of the target organ damage.
If hypertension is not diagnosed, measure the person’s clinic blood pressure at least every 5 years subsequently, and consider measuring it more frequently if the person’s clinic blood pressure is close to 140/90 mmHg.
Any other information in this regards, I shall be more then happy to answer at the earliest.
Dr. Ashok Kapoor,MBBS, MD(Int. Medicine,DM(Cardio), F.CARD,MCCP
Physician &Cardiologist
Director
Getwell Medical Center/Curewell Diagnostic Centre
P.O.Box-31690
2nd Floor, Getwell Building, Bank Street Bur Dubai
Dubai. UAE
04 359 5935. 00971504505865 Mobile
E mail: ashukap@emirates.net.ae
google Map for the Centre: https://maps.app.goo.gl/3Xbdv