5 ways to diagnose high blood pressure

Written by: Dr Ahmed Elghamaz
Published: | Updated: 20/06/2023
Edited by: Cal Murphy

Hypertension is very common in our society. By the age of 60, half of our population has high blood pressure. It’s important to keep a check on your current blood pressure level because it can change with time. Leading London cardiologist Dr Ahmed Elghamaz explains.

What are the causes and symptoms of hypertension?

High blood pressure is associated with many aspects of modern life, such as the high salt content in our foods, insufficient exercise and a high alcohol intake, as well as also having a hereditary element. Occasionally there can be a specific underlying disease causing it.

High blood pressure is important because it increases the risk of strokes, heart attacks and premature death. Often, patients have no symptoms, but it can cause headaches and other vague symptoms of feeling generally unwell.

 

 

How is hypertension diagnosed?

It’s really important to be sure that a diagnosis of high blood pressure is correct and guidelines emphasise the importance of 24-hour blood pressure monitoring and also checking if there are any changes in the heart and other parts of the body associated with high blood pressure. These tests may help to determine whether there is sustained high blood pressure that needs treating and if there is, whether it’s reasonable to treat with lifestyle changes alone in the first instance or to also treat early with medication.

Tests that can be helpful if assessing patients with high blood pressure include:

 

1. Electrocardiogram (ECG)

This gives information about the heart’s rhythm. It also can give an indication of whether the heart may have been affected by high blood pressure.

 

2. Echocardiogram (an ultrasound test of the heart)

An echocardiogram can assess the condition of the heart, its ability to pump blood, and the condition of the valves. The heart walls may become thickened due to high blood pressure and the shape of the main artery coming out of the heart, the aorta, can also be affected. These can be important changes that help indicate whether we should advise treating with medication now or whether it is reasonable to try lifestyle changes to control the blood pressure first.

 

3. 24-hour blood pressure monitor

A 24-hour blood pressure monitor is a blood pressure monitor connected to an arm cuff that you take home with you. It measures your blood pressure typically every half an hour during the day and every hour at night to give daytime and night-time blood pressure averages. This information can help guide whether you have sustained hypertension or so-called 'white coat' hypertension where your blood pressure tends to go up when a doctor or nurse measures it.

 

4. Blood tests 

We generally like to look at a number of blood tests in patients with suspected high blood pressure. The kidney function and the level of some salts, such as sodium and potassium in the blood are particularly important and can help give clues about whether there might be an unusual underlying cause for hypertension. We would normally check that there is no sign of diabetes and also assess the cholesterol and other lipid levels to help to assess the overall risk of future heart attacks and strokes.

 

5. Exercise testing

Sometimes it can be helpful to assess heart and blood pressure levels during and after exercise. The blood pressure change with exercise is another measurement that can help distinguish sustained hypertension from a “white coat” effect.

 

Treating high blood pressure

Luckily, there are many ways of lowering blood pressure. In some patients, it’s possible that non-drug treatments, like reducing salt intake, reducing alcohol consumption, and/or undertaking regular exercise can significantly lower blood pressure without the need for medication. If medication is needed, there are lots of options to find the treatment that suits you best.

 

For those patients who are on treatment for high blood pressure, it may be worth checking whether your current blood pressure levels are still optimal for reducing your future risk of strokes and heart attacks. A recent US study has suggested that traditional blood pressure targets may be higher than ideal.

 

It takes time for new research findings to become adapted into clinical guidelines and it may be worth a specialist assessment to check that your blood pressure level is optimal.

 

 

 

Learn how Dr Elghamaz can help you look after your cardiovascular health by arranging a consultation with him via his Top Doctors profile.

By Dr Ahmed Elghamaz
Cardiology

Dr Ahmed Elghamaz is highly respected consultant cardiologist based in London. He specialises in the assessment and treatment of palpitations, breathlessness and high blood pressure and is also renowned for his expertise in complex coronary intervention, stress echocardiogram and coronary artery disease.

Dr Elghamaz qualified in medicine at Ain Shams University, Egypt in 1996 before relocating the the UK to pursue further training, including an honorary research fellowship at Brighton and Sussex University Hospitals. He completed his specialist training in cardiology and coronary intervention in London and was then appointed as a consultant cardiologist at Northwick Park Hospital. Dr Elghamaz is now clinical lead for coronary intervention at the hospital and is renowned for his numerous innovative contributions which have advanced the site’s cardiology service. He sees private patients at both The London Clinic and Northwick Park Hospital.

Additional to his clinical responsibilities, Dr Elghamaz is head of interventional research at Northwick Park Hospital and is highly esteemed in the field of cardiology research. He has developed and established into practice a number of advanced techniques, including a novel approach to the assessment of fractional flow reserve and additionally has several patents for pioneering technology.

Dr Elghamaz is widely regarded as a leading expert in his field and is regularly invited to speak at key national and international meetings. His numerous publications feature in peer-reviewed journals and he is a member of many professional bodies, including the British Cardiac Society and the European Association of Percutaneous Coronary Intervention. As a distinguished name in cardiology, he also holds positions including membership of the European Society of Cardiology’s acute cardiac care working group and is co-founder of the South of England Chronic Total Occlusion Club (SECTO).

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