Nearly 3 in 10 Adults Have High Blood Pressure: Simple Tests Can Help Identify Cardiovascular Risk

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High blood pressure often develops without noticeable symptoms, but a few simple measurements and routine laboratory tests can help detect cardiovascular risk before serious complications occur.

High blood pressure is one of the most common cardiovascular risk factors in the world — and one of the most difficult to detect without regular health checks.

The condition is frequently called a “silent killer” because many people with hypertension have no obvious symptoms. According to the World Health Organization (WHO), an estimated 1.4 billion adults aged 30 to 79 had hypertension worldwide in 2024, representing about one-third of people in that age group.

In Brazil, the burden is particularly significant. The WHO's 2025 country profile estimates that 46% of Brazilian adults aged 30–79 have hypertension. Of the approximately 55.7 million people in this age group living with the condition, around 34.5 million do not have their blood pressure under control.

The good news is that identifying hypertension does not necessarily require sophisticated technology. In many cases, the first — and most important — step is a simple blood-pressure measurement.

Blood Pressure: The First and Most Important Check

Blood pressure is measured using two numbers.

The systolic pressure represents the pressure in the arteries when the heart contracts, while the diastolic pressure represents the pressure when the heart relaxes between beats.

According to the WHO, hypertension is diagnosed when blood pressure measurements taken on different days show systolic pressure of 140 mmHg or higher and/or diastolic pressure of 90 mmHg or higher.

Brazil's Ministry of Health similarly defines hypertension as persistent blood pressure at or above 140/90 mmHg.

However, a single elevated reading does not necessarily mean that a person has hypertension.

Blood pressure can temporarily rise because of stress, physical activity, caffeine, pain or other circumstances. For this reason, healthcare professionals may recommend repeated measurements or monitoring outside the doctor's office to confirm the diagnosis.

The Brazilian Ministry of Health recommends that, whenever possible, blood pressure outside the clinical setting should be considered both when confirming hypertension and when office readings remain elevated despite treatment.

Why High Blood Pressure Matters

Hypertension is not simply a number on a blood-pressure monitor.

Over time, persistently elevated pressure can damage blood vessels and place additional strain on the heart. It is an important risk factor for heart attack, stroke, heart failure and kidney disease.

The condition can also contribute to damage in other organs, particularly when it remains untreated or poorly controlled for years.

This is why identifying hypertension early is so important: cardiovascular risk is not determined by blood pressure alone. Doctors also consider factors such as cholesterol levels, blood glucose, kidney function, smoking, age, family history and the presence of diabetes or established cardiovascular disease.

Simple Tests That Can Reveal Cardiovascular Risk

Once elevated blood pressure is identified, healthcare professionals may request a series of relatively simple tests to assess overall cardiovascular health.

These tests do not replace blood-pressure measurement, nor does every person necessarily need every test. The appropriate evaluation depends on age, medical history, symptoms, risk factors and the healthcare professional's assessment.

1. Blood Pressure Measurement

This remains the essential starting point.

Regular measurements can identify elevated blood pressure before symptoms appear. The WHO emphasizes that measuring blood pressure is a quick and painless way to detect hypertension.

The Brazilian Ministry of Health recommends that adults over 20 have their blood pressure checked at least once a year, with more frequent measurements for people with a family history of hypertension.

2. Cholesterol Test

A blood test measuring total cholesterol, HDL cholesterol, LDL cholesterol and triglycerides can help identify another major cardiovascular risk factor.

High levels of certain blood lipids can contribute to the formation of atherosclerotic plaques inside arteries.

Brazil's Ministry of Health includes lipid measurements among the laboratory tests used when evaluating cardiovascular risk in people with hypertension.

3. Blood Glucose

A fasting blood glucose test is another simple laboratory examination that can provide important information.

High blood glucose may indicate diabetes or impaired glucose regulation, both of which can substantially increase cardiovascular risk.

For people with hypertension, identifying diabetes is particularly important because the combination of high blood pressure and diabetes can increase the risk of cardiovascular and kidney complications.

4. Kidney Function Tests

The kidneys and blood pressure are closely connected.

Hypertension can damage the kidneys, while kidney disease can contribute to elevated blood pressure. This makes kidney-function testing an important part of cardiovascular risk assessment.

A commonly used blood test is serum creatinine, which can be used to estimate the glomerular filtration rate — an important indicator of kidney function.

The Brazilian Ministry of Health includes creatinine and estimated kidney filtration among recommended assessments in the evaluation of hypertension.

5. Urine Test

A basic urine examination can also provide useful information.

A urinalysis may help identify abnormalities that suggest kidney involvement or other conditions associated with cardiovascular risk.

In selected patients, doctors may also request an albuminuria test to detect small amounts of albumin in the urine. According to Brazilian primary-care guidance, albuminuria may be particularly relevant for people with diabetes, metabolic syndrome or multiple cardiovascular risk factors.

6. Electrocardiogram

An electrocardiogram (ECG) is another relatively simple examination that records the heart's electrical activity.

In people with hypertension, an ECG can help identify certain changes that may indicate cardiovascular involvement. It is also useful when doctors are investigating symptoms or other clinical concerns.

Brazilian Ministry of Health guidance includes a conventional ECG among the screening examinations that may be used in the evaluation of patients with hypertension.

7. Body Weight and Waist Circumference

Not every cardiovascular risk assessment requires a laboratory test.

Measurements such as body weight, body mass index (BMI) and waist circumference can provide important information about metabolic and cardiovascular risk.

Excess body weight is a recognized risk factor for hypertension, while abdominal obesity is associated with metabolic abnormalities that can increase cardiovascular risk.

When More Sophisticated Tests Are Necessary

Routine screening does not mean that everyone needs extensive imaging or specialized examinations.

Additional tests are generally requested when there is a specific clinical reason.

For example, an echocardiogram may be considered when an ECG suggests enlargement of the heart's left ventricle or when there is a clinical suspicion of heart failure. Kidney ultrasound or Doppler studies may be appropriate when kidney disease or renovascular disease is suspected.

The important point is that cardiovascular assessment should be individualized rather than based on a universal list of tests.

The Risk Is More Than Just a Blood-Pressure Number

Two people can have exactly the same blood-pressure reading but very different overall cardiovascular risks.

A doctor may consider the combination of:

• Blood pressure levels
• Age
• Smoking
• Cholesterol
• Diabetes
• Kidney function
• Body weight
• Family history of premature cardiovascular disease
• Previous heart attack or stroke
• Evidence of damage to organs such as the heart or kidneys

Brazilian primary-care guidance uses this broader assessment to classify cardiovascular risk among people with hypertension.

This approach is important because treating hypertension is not simply about lowering a number on a monitor. The ultimate objective is to reduce the probability of serious cardiovascular events.

Don't Wait for Symptoms

One of the biggest challenges in combating hypertension is that people often feel perfectly well while their blood pressure is elevated.

The WHO notes that many people with hypertension do not experience symptoms. The only reliable way to know whether blood pressure is high is to measure it.

When symptoms such as severe headache, chest pain, difficulty breathing, visual disturbances or confusion occur in the context of very high blood pressure, urgent medical evaluation may be necessary.

That is why routine screening is so valuable.

A blood-pressure measurement takes only a few minutes, while basic blood and urine tests can reveal risk factors that might otherwise remain unnoticed.

Prevention Starts With Knowing Your Numbers

Hypertension is common, but it is also one of the cardiovascular risk factors that can be detected relatively easily.

Regular blood-pressure checks, combined with appropriate laboratory testing when indicated, can help identify hypertension, diabetes, abnormal cholesterol levels and kidney problems before they progress to more serious complications.

Lifestyle also plays an important role. Maintaining a healthy weight, being physically active, reducing excessive salt intake, avoiding tobacco and moderating alcohol consumption can help reduce cardiovascular risk and support blood-pressure control.

The message is simple: you don't have to wait until something feels wrong to check your cardiovascular health.

A blood-pressure monitor, a routine blood test and a basic medical evaluation may provide some of the most valuable information about your future health.

And when it comes to hypertension, knowing your numbers can be the first step toward preventing a heart attack, stroke or kidney disease.

This article is intended for general health information and does not replace an evaluation by a qualified healthcare professional. The appropriate tests and frequency of screening vary according to each person's age, medical history, symptoms and cardiovascular risk.