High Blood Pressure (Hypertension)

Diagnosis & Tests

Accurate measurement of blood pressure is the most important part of diagnosing  hypertension in older adults. Blood pressure can vary. That’s why the diagnosis of hypertension requires at least 3 blood pressure readings taken on two separate visits to the healthcare professional.


Many people get nervous and their blood pressure increases when they see a healthcare provider. This is called "white-coat" hypertension. If this happens, the healthcare provider may ask a person to measure their blood pressure at home several times and report the results. Simple blood pressure monitors are available at a reasonable cost. 

People may need 24-hour blood pressure monitoring if they have:

  • Possible “white-coat” hypertension.
  • Extreme blood pressure variability.
  • A possibility of resistant hypertension.
  • Possible hypotension, including postural hypotension.

Health Assessment

Once a person has high blood pressure, the healthcare provider will:

  • Check for any diseases that might be causing high blood pressure or diseases that high blood pressure causes. These conditions can include heart problems, kidney disease, diabetes, or eye problems.
  • Take a routine history and do a physical examination. Blood and urine tests may also be needed. 

If a person has high blood pressure, a healthcare provider may check for:

  • Orthostatic, or postural hypotension. This is very low blood pressure when the person stands up. The blood pressure may then recover and be elevated.  Providers look for orthostatic hypotension by measuring blood pressure while a person is lying down, and then after standing up. Checking for orthostatic hypotension is important for older people, as drops in blood pressure can lead to episodes of fainting or falling. 
  • Secondary hypertension. Renovascular disease (narrow arteries to the kidneys) is the most common form of secondary hypertension among older adults. Sleep apnea and use of NSAIDs (type of pain medication) are causes of secondary hypertension.


Last Updated March 2023

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