A value of 140/85 mmHg is accepted as the upper limit of a normal blood pressure. Systolic or diastolic values just above this are borderline; values from 150/90 onward are definitely elevated. Only repeated measurements may help in deciding whether there is sustained hypertension or whether there is intermittent (“labile”) hypertensive episodes, or stress-related hypertension (“white-coat hypertension”). With physical exercise and mental stress, there may be substantial pressure increases up to systolic values of 300 mmHg. Just as with a measurement at rest, a single measurement of blood pressure on exertion is not enough. Reliable diagnostic information is however provided by 24 hours ambulatory monitoring. Chronic observations have shown that patients with borderline hypertension and elevated arterial pressure with exercise often develop persistent hypertension. However, also complete normalization over time is not uncommon.
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