According to the Centers for Disease Control and Prevention, one third of the United States population suffers from hypertension. Approximately one fifth are symptom-free and unaware of their diagnosis.
Hypertension is a state of high blood pressure beyond what is considered normal for the individual. When a person's blood pressure is increased, there is a higher risk of heart disease, heart attacks, strokes and kidney failure. The narrower the arteries become, the more the heart needs to pump and the higher the blood pressure becomes. Read more in this patient education guide.
Doctors Who Treat High Blood Pressure
Specialists that diagnose and monitor hypertension listed in this patient education guide include:
Ophthalmologists. Doctors who specialize in the health of the eyes and vision. They examine the retina for changes that are associated with high blood pressure.
Cardiologists. Physicians that maintain the health of the heart and circulatory system. They rule out any heart involvement with hypertension by performing and interpreting electrocardiograms (EKG) and other additional tests that may be necessary.
Nephrologists. Physicians who treat the kidneys and urinary system. They rule out any kidney dysfunction or involvement.
Additional physicians that diagnose and treat hypertension include:
- Internists
- Gerontologists
- Pediatricians
- Obstetrician/Gynecologists
- Emergency Room doctors
- General practitioner (family physician)
How to Prepare for Your High Blood Pressure Doctor Visit
Once you have your appointment confirmed, there are certain actions that you can take to make sure you have the most accurate reading of your blood pressure and to maximize the benefit of the visit:
- Ask your doctor if any of your current medications (which includes cold medications) could elevate your pressure. If so, the medication should be either discontinued or altered for the time of the test under advisement of the physician in charge.
- Cut back on caffeine 3-days before your visit. That includes tea, colas, and chocolate.
- Do not smoke 3-days prior to your visit.
- Before your blood pressure is measured, sit quietly for a minimum of 5 minutes with both feet on the floor. Alternatively, lie on your left side while on the examination table for 5 minutes.
- Keep hydrated and avoid salty foods for a week leading up to the exam.
Questions to Ask Your Doctor About High Blood Pressure
From your initial diagnosis throughout your treatment and care, you will have questions about your high blood pressure. Our patient education guide lists helpful questions for you and your doctor to discuss so you can make
informed decisions about your condition.
Questions About My Diagnosis
- Can hypertension be cured?
- What medical conditions are associated with high blood pressure?
- What is my prognosis?
- Should I see a specialist?
- How often should I be screened?
Questions About My Treatment
- Why did you choose this particular medication for me? Are there side-effects?
- Are there generic equivalents? Are they as effective?
- Will this medication interact with the other drugs that I am taking?
- What are the risks of not taking medication?
Questions About My Lifestyle and Family
- Is hypertension genetic?
- What foods should I avoid? Can I drink alcoholic beverages?
- Is there a special diet or meal plan you recommend?
- Will losing weight cure my hypertension? What is my ideal weight?
- How much exercise should I do? Are there exercises I should avoid?
- Will meditation and other alternative therapies lower my blood pressure?
Common Tests or Labs to Diagnose High Blood Pressure
Hypertension is diagnosed by three separate readings of high blood pressure taken at least one week apart. But once diagnosed, your doctor may send you for additional tests and labs to see if your elevated pressure is effecting the production of any other organs or systems. Read more in this patient education guide.
| Test Site |
Test Name |
What is Tested |
Normal Range |
| Arm |
Blood Pressure measurement |
Systolic and Diastolic pressure.
If abnormal, it is repeated twice with a one-week interval
|
Systolic (top number) = 120 or less
Diastolic (bottom number) = 80 or less
|
| Chest |
Electro-cardiogram (EKG or ECG) |
Measures the cardiac electrical activity and records it onto lined tracings. The peaks, valleys, intervals and rate are interpreted.
|
The cardiac beat should have a regular rhythm.
Normal rates range between 60 to 100 p minute.
|
| Blood |
SMA 12 |
Serum electrolyte levels like sodium and potassium are checked, along with sugar, cholesterol and creatinine. |
Sodium =135-145 mEQ/L
Potassium= 3.7-5.2 mEq/L
Glucose=70-100mg/dL fasting
Cholesterol=150-199
LDL= less than 100
HDL= 60 and above
Creatinine=.8-1.4 mg/dL
|
| Eye |
Retinal examination Optomap |
View of the back of the eye for:
- Retina (lining)
- Optic nerve
- Blood vessels
|
Normal would be a smooth clear retina with no constriction of nerve or vessels.
Abnormal signs include:
- Cotton wool spots
- Flame hemorrhages
- Blood specks
|
| Urine |
Urinalysis (dipstick) |
Presence of:
|
There should be no trace of sugar, blood or protein. |
| Urine |
24-Hour Urine Test |
Creatinine Clearance
Total Protein
Aldosterone level
VMA (Vanillyl
Madelic Acid)
|
Creatinine Clearance=88-128 m./min in
women; 97-137 ml/min in men
Total protein= less than 150mg/24 hrs
Aldosterone=2-26 mcg
VMA=2-7 mg/24 hrs
|
Common Medications and Treatments for High Blood Pressure
Chart I: Medications for Control of Hypertension
| Category |
Common Drugs |
How It Works |
| ACE Inhibitors |
Accupril (quinapril)
Aceon (perindopril)
Altace( ramipril)
Capoten (captopril)
Lotensin (benazepril)
Mavik (trandolapril)
Monopril (fosinopril)
Prinivil (lisinopril)
Univasc (moexipril)
Vasotec (enalapril)
Zestril (lisinopril)
|
Angiotensin Converting Enzyme (ACE) Inhibitors stop production of the angiotensin II hormone, which makesvessels relax and lowers pressure. |
| Alpha beta blockers |
Coreg (carvedilol)
Normodyne (labetalol)
Trandaate (labetalol)
|
Helps to slow the heartbeat so blood pumped through vessels declines.
Decreases nerve impulses to vessels.
|
Alpha-Blockers
(Alpha Adrenergic-Antagonists)
|
Flomax (Tamsulosin)
Cardura (Doxazosin)
Minipress (Prazosin)
Terazsin
Uroxatral (Alfuzosin)
|
Decreases nerve stimulation to the blood vessels.
Reduces pressure of blood flow through the vessels
|
Angiotensin Antagonists
(Angiotensin Blockers)
|
Atacand (Candesartan)
Avapro (Irbesartan)
Benicar (Olmesartan)
Cozaar (Losartan)
Diovan (Valsartan)
Edarbi (Azilsartan)
Micardis (Telmisartan)
Teveten (Eprosartan)
|
Protects blood vessels from affects of Angitensin II - this widens blood vessels thereby decreasing pressure. |
| Calcium Channel Blockers (CCBs) |
Amlodipine-Norvasc
Aranidipine (Sapresta)
Azelnidipine (Calblock)
Barnidipine (HypoCa)
Benidipine (Coniel)
Cilnidipine (Atelec,Cinalong)
Clevidipine (Cleviprex)
Isradipine (DynaCirck,Prescal)
Efonidipine (Landel)
Felodipine (Plendil)
Lacidipine (Motens)
Lercanidipine (Zanidipip)
Manidipine (Calslot,Madipine)
Nicardipine (Cardene)
Nifedipine (Procardia, Adalat)
Nilvadipine (Nivadil)
Nimodipine (Nimotop)
Nisoldipine(Baymycard,Sular,Syscor)
Nitrendipine (Cardif,Nitrepin)
Pranidipine (Acalas)
Veerapamil (Calan,Verelan)
|
Prevents calcium entry into muscle cells of vessels and heart.
Relaxes blood vessels.
|
| Diuretics |
Thiazides-Esidrix, Zaroxolyn
While there are many diuretics, only the above two are used to lower blood pressure
|
Rids the body of excess water and sodium Often called "water pills."
Works to help the function of kidneys.
|
| Nervous System Inhibitors |
Clonidine
Guanabenz (Wytensin)
Guanfacine
Methyldopa (Aldomet,Aldoril,Dopamet Dopegyt)
|
Moderates nerve impulses to relax blood vessels- dilates vessels to decrease pressure
Alpha-adrenergic agonist |
| Vaso-Dilators |
Diamox (acetazolamide)
Thalitone(chlorthalildone)
Lozol (Indapamide)
Metolazone (zaroxolyn)
Hydralazine
Sodium Nitropruside
(Minoxidil)
|
Relaxes vessel wall musculature to wide the blood vessels and thereby decrease pressure. |
