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Hypertension, or high blood pressure, is often called a "silent
disease" because you usually don’t know that you have it; there are no
outward symptoms or signs. Nonetheless, it damages the body and eventually may
cause such problems as heart disease.
Therefore, it’s important to regularly monitor your blood pressure,
especially if it’s ever been high or above the "normal" range, or if
you have a family history of hypertension. Because hypertension can cause heart
disease, you can also undergo various tests to determine if you have heart
disease.
How is my blood pressure measured?
Your doctor or health care provider can check your blood pressure during a
physical examination. (You can also check your own blood pressure at home.)
Blood pressure is measured with a device known as a sphygmomanometer, which
consists of a stethoscope, arm cuff, dial, pump, and valve. (A digital blood
pressure monitor provides an electronic blood pressure reading.)
Your blood pressure is measured in the following manner:
- The cuff is wrapped over your arm and inflated with the pump
until it stops the flow of blood.
- The valve lets air out of the cuff, which starts the blood flow
again.
- The stethoscope is placed under the cuff to listen for the
sound of blood rushing back through the artery. The first sound is the
systolic blood pressure, the force of the blood against the artery walls as
the heart beats.
- The second number, the diastolic pressure, occurs when the
sound isn’t heard anymore; this is the blood pressure between heartbeats.
The blood pressure reading is measured in millimeters of mercury (mm Hg) and
is written systolic over diastolic (e.g., 120/80 mm Hg, or "120 over
80"). According to the most recent hypertension treatment guidelines, a
normal blood pressure is less than 120/80 mm Hg.
What are the tests for heart disease?
In addition to measuring your blood pressure, your doctor will ask about your
medical history (whether you’ve had heart problems before), assess your risk
factors (whether you smoke, have high cholesterol, diabetes etc.), and talk
about your family history (whether any members of your family have had heart
disease, which is another risk factor).
Your doctor will also conduct a physical examination. As part of this
examination, he or she may listen to your pulses with a stethoscope for a bruit,
a whooshing or swishing sound that indicates that the artery may be blocked.
Your doctor may also check the pulses in your arm and ankle to determine if they
are weak or even absent. Your doctor may choose to do this or other additional
tests as well.
In general, testing for heart disease is most useful in patients who have
signs or symptoms of heart disease identified during the history and physical
examination. Among the most commonly used are the following:
- Electrocardiogram (EKG or ECG):
measures the electrical activity, rate and rhythm of your heartbeat via
electrodes attached to your arms, legs, and chest. The results are recorded
on graph paper and interpreted by your physician.
- Echocardiogram: This test sends ultrasound waves that provide
pictures of the heart's valves and chambers so the pumping action of the
heart can be studied.
- Exercise stress test: You exercise on a stationary bicycle or
treadmill to increase your heart rate while EKG readings are taken. A stress
test can also be combined with an echocardiogram or nuclear medicine x-ray
to get additional information.
- Cardiac catheterization: a catheter, a small flexible tube, is
inserted into an artery and guided to the coronary arteries. Your doctor can
locate any blockages in the arteries and can also observe pressure and blood
flow in the heart.
- Ultrasound: uses high-frequency sound waves to look for
blockages in blood vessels in the neck (carotid arteries).
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