Ambulatory monitoring of blood pressure involves wearing a device that inflates and deflates automatically every 15 to 20 minutes and records the readings.  This type of monitoring is usually conducted for a period of 24 to 48 hours and provides measurements that are considered to be more accurate than when taken in a doctor’s office.  However, ambulatory monitoring is obviously more expensive than when conducting home monitoring for high blood pressure. 

The inflated blood pressure cuff may not adequately compress the arteries for people with unusually stiff arteries.  This may result in a condition referred to as pseudo hypertension in which measurements are sometimes higher than their actual blood pressure.  In these circumstances, an individual’s blood pressure may be either normal or high, but are not as high as the measurement may indicate.  When people experiencing pseudo hypertension are given high blood pressure medicine, the blood pressure may drop to a level that is considered too low, resulting in the physical sensation of feeling lightheaded. 

In order to decide if other conditions are contributing or causing high blood pressure, your physician will usually ask various questions about symptoms.  Some examples may be that if you are snoring or are experiencing extraordinary sleepiness during the daytime, your doctor may explore whether you possibly have sleep apnea.  Laboratory tests and a physical examination are frequently conducted to examine the possible causes.  Some of the tests typically conducted include urinalysis and blood tests.  Also, your doctor may want to see if there has been any damage to your heart as a result of your high blood pressure, by conducting tests such as an electrocardiography.  Occasionally, your doctor may also want to include additional testing such as exercise stress testing when it seems necessary.