Assessments & Normal Ranges

Diagnostic Testing
A hypertension assessment initially involves a thorough medical history assessment observing the duration and severity and symptoms and signs of hypertension. The medical history assessment involves questions about the individual’s risk factors, and symptoms and signs, of coronary heart disease (CHD), heart failure, renal disease, and endocrine disorders [1].

In addition to a medical history assessment, an accurate resting blood pressure (BP) reading is a critical part of the assessment of hypertension. Classification of hypertension is based on the average of two or more BP readings, at two or more separate visits, after being seated quietly for a minimum of 5 minutes. Caffeine, exercise and smoking should be avoided for at least 30 minutes prior to measurement[2] . As indicated in the “Scope of Hypertension”, hypertension is defined as systolic BP of 140mm Hg or greater, having a diastolic BP of 90mm Hg or greater, or taking antihypertensive medica








YouTube Video: High Blood Pressure Tips & Treatments: Importance of Regular Blood Pressure Checks


Other diagnostic testing includes urinalysis; hematocrit; blood chemistry; an electrocardiogram; creatine clearance; chest X-ray; and serum calcium, phosphate and uric acid assessments.



Exercise Testing


=====A graded exercise test is useful in screening for hypertension and CHD, however should not be conducted on high risk hypertension patients (systolic BP greater than 200mm Hg or diastolic BP greater than 110mm Hg at rest)[3] . For this reason, prior to conducting a graded exercise test, clients should undergo a detailed medical history assessment and their resting BP should be collected in both the supine (lying) and standing positions. Indications for terminating the exercise test is a significant decrease in systolic BP (>10mm Hg) or significant increase (systolic BP >250mm Hg or diastolic BP >115mm Hg) from baseline (despite an increase in workload)[4] .
An exaggerated BP response above the 95th percentile of sex-specific, age-predicted values, during stage 2 of the Bruce Protocol treadmill graded exercise test has been associated with an increase risk of future risk of developing hypertension[5].



Table 1:Sex-specific predicted 95th percentile values for systolic and diastolic BP at stage 2 of exercise

Age
Exercise SBP
Exercise DBP

Male

20-24
190
93
25-29
193
97
30-34
196
101
35-39
198
103
40-44
201
105
45-49
204
106
50-54
208
107
55-59
211
107
60-64
214
107
65-69
218
106

Female

20-24
165
92
25-29
169
95
30-34
173
98
35-39
177
100
40-44
181
102
45-49
186
103
50-54
190
104
54-59
195
104
60-64
199
103
65-69
204
102
Table from: J. Singh et al., 1999[6]
BP_Assessment_on_treadmill.jpg




























HOME
  1. ^
    Contractor, A. & Gordon, N. Cited from: Ehrman, J. K., Gordon, P. M., Visich, P. S., & Keteyian, S. J. (2009). Clinical Exercise Physiology. Human Kinetics.
  2. ^
    Contractor, A. & Gordon, N. Cited from: Ehrman, J. K., Gordon, P. M., Visich, P. S., & Keteyian, S. J. (2009). Clinical Exercise Physiology. Human Kinetics.
  3. ^ =====
    Contractor, A. & Gordon, N. Cited from: Ehrman, J. K., Gordon, P. M., Visich, P. S., & Keteyian, S. J. (2009). Clinical Exercise Physiology. Human Kinetics.
  4. ^ Contractor, A. & Gordon, N. Cited from: Ehrman, J. K., Gordon, P. M., Visich, P. S., & Keteyian, S. J. (2009). Clinical Exercise Physiology. Human Kinetics.
  5. ^
    Singh, J., Larson, M., Manolio, T., O’Donnell, C., Lauer, M., Evans, J., Levy, D. (1999). Blood pressure response during treadmill testing as a risk factor for new-onset hypertension. The Framingham Heart Study. Circulation; 99(14): 1831-1836.
  6. ^
    Singh, J., Larson, M., Manolio, T., O’Donnell, C., Lauer, M., Evans, J., Levy, D. (1999). Blood pressure response during treadmill testing as a risk factor for new-onset hypertension. The Framingham Heart Study. Circulation; 99(14): 1831-1836.