The most important tool for diagnosing hypertension is the blood pressure monitor. If multiple resting measurements are inconclusive, a 24-hour measurement can be used to relate blood pressure values to activity for diagnosis. It is also important in the initial diagnosis to exclude secondary hypertension. This can possibly be cured by eliminating the causes. The diagnosis of high blood pressure also includes regular examinations by the physician. In doing so, he pays particular attention to the organ systems that are frequently damaged in hypertension.
Classification of hypertension
The guidelines of the German Hypertension League currently provide the following classification for blood pressure levels – based on European recommendations:
| Category | Systolic (mm Hg) | Diastolic (mm Hg) |
|---|---|---|
| Optimal | < 120 | < 80 |
| Normal | 120–129 | 80–84 |
| High Normal | 130–139 | 85–89 |
Manifest Hypertension Category
| Category | Systolic (mm Hg) | Diastolic (mm Hg) |
|---|---|---|
| Grade 1 hypertension (mild) | 140–159 | 90–99 |
| Grade 2 hypertension (moderate) | 160–179 | 100–109 |
| Grade 3 hypertension (severe) | ≥ 180 | ≥ 110 |
| Isolated systolic hypertension (further classification also into 3 degrees). | ≥ 140 | < 90 |
Notes on the interpretation of blood pressure values
- If systolic and diastolic blood pressure fall into different categories, the higher one applies.
- There is a particularly high risk when isolated systolic hypertension is accompanied by particularly low diastolic blood pressure (60-70 or lower).
- The data usually apply only under resting conditions, since physical stress increases blood pressure even in healthy individuals. If the blood pressure rises only under stress disproportionately, that is, beyond the normal adaptation reaction, it is called stress hypertension.
A “manifest hypertension”, as the medical profession calls the pathologically elevated blood pressure, is thus present at a systolic value from 140 mm Hg and / or a diastolic value from 90 mm Hg – provided that it was measured several times on different days under standard conditions, that is, at rest. This definition applies without age restriction.
Incidentally, this form of blood pressure measurement goes back to the Italian physician Scipione Riva-Rocci (1863-1943), which is why the abbreviation RR (according to Riva-Rocci) is commonly used for blood pressure measured on the arm.
