What Does a High Blood Pressure Diagnosis Mean?

Blood pressure is measured as two numbers — systolic (pressure when your heart beats) over diastolic (pressure when your heart rests), in mmHg.

Hypertension means blood pressure that is persistently above the healthy range on repeated measurements. A single high reading doesn't diagnose it — stress, pain, caffeine, or anxiety (white coat effect) can all raise it temporarily.

Hypertension affects approximately 34% of Australian adults — and nearly half are unaware they have it. It often has no symptoms, which is why it's sometimes called "the silent killer": it causes progressive damage to blood vessels, heart, kidneys, and brain over years, often without warning.

Your GP will measure blood pressure on at least two separate visits before diagnosing hypertension. They may also recommend:

Home blood pressure monitoring (HBPM) — taking readings twice a day for 7 days gives a much more accurate picture than a single clinic reading. The RACGP recommends this as the standard approach before starting treatment. Use the AskMyGP BP Log to record and track your readings →

24-hour ambulatory monitoring (ABPM) — a portable device worn for a day that records readings every 20–30 minutes, including during sleep. Particularly useful for ruling out white coat effect or identifying nocturnal hypertension. This is arranged through your GP or specialist, not a home device.

Once confirmed, your GP will typically organise blood tests (eGFR, urine ACR, fasting glucose, full lipid profile) and an ECG to check for organ effects and cardiovascular risk.

Lifestyle changes alone can lower systolic blood pressure by 5–15 mmHg. They're part of management at every stage, even if medication is also needed.

When lifestyle changes alone don't bring blood pressure to target — or when blood pressure is high enough to warrant prompt treatment — medication is added. This doesn't mean lifestyle changes have failed; the two work together.

First-line medications used in Australia include ACE inhibitors, angiotensin receptor blockers (ARBs), calcium channel blockers, and thiazide diuretics. The choice depends on your age, ethnicity, kidney function, and whether you have diabetes, heart disease, or other conditions.

Most people need only one or two medications, taken once daily. Side effects vary by drug class — your GP will discuss these. Blood pressure medications are among the most commonly prescribed in Australia and generally very safe.

The Heart Foundation recommends a target of below 130/80 mmHg for most people with hypertension, particularly those with diabetes, chronic kidney disease, or established cardiovascular disease.

For older patients (over 75), targets are individualised — aiming too aggressively in frail patients can cause dizziness and falls. Your GP will set a target appropriate for your specific situation.

Blood pressure varies through the day and responds to seasons, stress, salt intake, sleep, and medications. Regular monitoring — whether at home or at your clinic — is how you and your GP know if treatment is working. Track your readings in the BP Log → Your GP will also use your blood pressure alongside other factors to calculate your overall cardiovascular disease risk →