How could other health problems affect my treatment?

To decide on the best way to treat your high blood pressure, your doctor will check to see if you already have coronary heart disease. Your doctor will also look for damage that your high blood pressure may have caused to your heart, brain, kidneys, eyes, or blood vessels. If you have damage to any of these areas, it could affect the treatment your doctor recommends to help lower your blood pressure. Keep reading to learn how your doctor checks for damage in each of these areas.

How Your Doctor Checks Your Heart for Damage

Your doctor will ask you whether you have previously had any of the following:



  • a heart attack
  • heart surgery
  • treatment for heart disease

Your doctor will also check your heart to see if there are any signs of heart disease. Your doctor will ask you about and look for the following:

  • Chest pain. Chest pain is also called angina. Be prepared to answer questions about where the pain is, what makes it come on, and how long it lasts.
  • Signs of heart failure. Using a stethoscope, your doctor can hear the abnormal heart sounds that may signal heart failure. Your doctor will also ask you about other signs, which include shortness of breath, fatigue, and swollen ankles and feet.
  • Risk factors that can contribute to heart failure. These risks include obesity and a history of heart problems.
  • Enlargement of your heart. This enlargement is called left ventricular hypertrophy. Your doctor checks for this condition during a physical exam, with a test called an electrocardiogram or with a chest X-ray. Sometimes you will need an echocardiogram or ultrasound of the heart to further check for this condition.

If your symptoms and medical history don't lead to a clear-cut diagnosis, your doctor may give you further tests to evaluate your heart function.

How Your Doctor Checks Your Brain for Damage

To see whether your high blood pressure has caused damage to your brain, your doctor will do the following:

  • ask you if you have ever had a stroke or mini-strokes, called transient ischemic attacks, or TIAs for short
  • check you for signs that you've had strokes or TIAs in the past

TIAs are warning signs that a stroke may occur in the future. TIAs and strokes have similar signs and symptoms. Both of them mean that you had decreased blood flow to your brain. Some of the signs your doctor may look for and ask you about are as follows.

  • Problems with movement, such as weakness, clumsiness, or paralysis. These are often on only one side of the body. In some cases, people may have weakness or clumsiness only in one hand. In other cases, one entire side of the body becomes paralyzed.
  • Numbness or a lack of feeling. This lack of feeling is often on only one side of the body.
  • Difficulty with abstract concepts. People who have had a stroke may have trouble speaking, doing math, or writing. They may also have trouble understanding speech.
  • Inability to recognize common things. This may include family members or common objects.
  • Dementia. This condition affects memory, understanding, and the ability to carry out the normal activities of daily life.
  • Changes in vision or hearing. Your doctor may check this by asking you to read something or by asking you questions about your hearing.
  • Personality changes. Your doctor may ask you or any family members who accompany you on your office visit questions about this.
  • Difficulty swallowing. Your doctor may refer to this as dysphagia.
  • Problems keeping your balance. Your doctor may refer to this as ataxia.
  • Dizziness. This may be by itself or include nausea and vomiting.

How Your Doctor Checks Your Kidneys for Damage

Your doctor will make sure that your kidneys are working properly and have not been damaged by your high blood pressure. To do this, the doctor takes a simple blood test and urinalysis. The blood flow to your kidneys will be affected if any of the following apply to you.

  • If you have high blood pressure and don't know, so you don't treat it.
  • If you don't take the medicine your doctor has prescribed for your high blood pressure or don't take the other actions your doctor has told you.
  • If your blood pressure becomes extremely high.

That's why it's extremely important that you get your blood pressure checked regularly and that you work with your doctor to follow your treatment plan if you have high blood pressure.

When blood flow to the kidneys is impaired, the kidneys are not able to work properly to rid the body of fluids. This is very serious. Usually there are no symptoms until the kidney disease has become very severe. At that time, some of the symptoms may include the following:

  • blood in the urine
  • swelling of the hands or feet
  • fever
  • urinary problems such as increased or decreased urination
  • further increase in blood pressure

How Your Doctor Checks Your Blood Vessels for Damage

To check whether your high blood pressure has damaged your blood vessels, your doctor will check the blood flow to the blood vessels in your arms and legs. If high blood pressure has caused problems with the blood vessels, your doctor may notice:

  • decreased or absent pulses
  • paleness of your skin
  • hair loss on your arms or legs

Your doctor may also ask you questions such as these, to determine if you have damage to your blood vessels.

  • Do you have discomfort or pain in your buttocks, leg, or foot caused by exercise or exertion?
  • Do you feel pain when your body is at rest?

How Your Doctor Checks Your Eyes for Damage

When blood pressure has remained extremely high for some time, it can lead to vision problems. The resulting damage to the retina - the back of the eye - is called retinopathy. Your doctor or eye doctor can diagnose this condition by using medicine to dilate your pupil and then using an instrument to look at the small blood vessels on your retina. Signs of damage are as follows:

  • narrowed blood vessels that have an abnormal color
  • bleeding in both the surface and the deep layers of the retina
  • feathery white areas called exudates
  • fluid collecting in the blood vessels, which causes them to bulge

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