How to diagnose arterial hypertension?

If I have measured my blood pressure and it came out high, does that mean I have hypertension?

Not necessarily. A single measurement is not enough to make a diagnosis, especially if it was taken in stressful situations, such as a medical consultation or an emergency visit due to pain or infection.

Blood pressure works like an engine’s revolutions: our body constantly regulates it according to its needs. For example, it increases during exercise when the muscles require more oxygen and nutrients and decreases while we sleep. It also rises in the morning upon waking or in situations of stress or pain.

So, which measurement is valid for diagnosis, and how should it be taken?

Since blood pressure varies depending on the circumstances, it is crucial that measurements are taken under similar conditions to ensure comparability. These conditions should reflect a state of rest and calm, meaning the body's "baseline revolutions."

For this reason, the European Society of Cardiology recommends that patients actively participate in their diagnosis and monitoring by measuring their blood pressure at home. This is because the presence of medical personnel can cause stress, leading to higher readings during consultations (a phenomenon known as "white coat syndrome"). In some cases, this effect can be so pronounced that people are diagnosed with hypertension when they do not actually have it.

Therefore, a single measurement or a random reading is not enough. A proper protocol must be followed to ensure reliable results.

Home blood pressure monitoring

It is one of the ways to establish the diagnosis. I prefer this method because it actively involves the patient. This process follows a structured algorithm to ensure that measurements are accurate and consistent:

1. Use a validated device with a properly fitting cuff.

To access tips on choosing the right device, click here.

2. Optimal conditions for measurement

Choose a quiet room with a comfortable temperature.
Avoid exercising, smoking, eating, or consuming coffee, tea, or other stimulants for at least 30 minutes beforehand.
If you are undergoing treatment, take the measurements before taking your hypertension medication.
Empty your bladder.
Remove clothing from your arm and avoid rolling up tight sleeves.

3. Position during measurement

Place the cuff in the center of your arm, with the lower edge 2-3 cm above the elbow crease.
Sit with your back supported, both feet flat on the floor (without crossing your legs), and your forearm resting on a table or armrest.
Relax for 5 minutes before starting the measurement and do not talk during the process.

4. Measurement process

Each time you measure your blood pressure, take two consecutive readings, allowing 1–2 minutes of rest between them.
The first time you measure your blood pressure, take readings on both arms.
If the difference between them is less than 10 mmHg in systolic pressure and 5 mmHg in diastolic pressure, you can use either arm for future measurements.
If the difference is greater, always use the arm with the higher values for subsequent measurements.

5. Frequency and analysis

Measure your blood pressure twice a day (morning and evening) for 7 consecutive days.
Avoid measuring your blood pressure immediately after waking up. Wait 10–15 minutes before taking the reading.
Average all measurements over the 7 days.
Some experts recommend discarding the first day's readings for a more accurate assessment.

The diagnosis of hypertension is established if the average of the measurements is equal to or greater than 135 mmHg for systolic pressure and/or 85 mmHg for diastolic pressure.

On this portal, I provide you with a tool to record your blood pressure readings online. Averages will be calculated automatically, and you will have access to additional statistics.

I encourage you to register on the website and take advantage of these resources.

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