Do I have high blood pressure?

Dear doctor, why is that when I go for a check up elsewhere I am told I have high blood pressure but when I do the check up at Mulago hospital, they say I am okay. I have been there twice with the same result. What causes this?
Allen

Dear Allen, hypertension (locally known as “pressure” is when blood pressure is consistently 140/90 or higher. In over 90 per cent of “pressure” patients, the cause is not found.
Persistent hypertension may lead to stroke, heart attack, and kidney failure, among others. Even moderately high pressure (140-159/90-99mmhg) may shorten life expectancy.
The readings may be normal in one place and higher in another because of measurement problems.
The machine may not be well maintained or is not appropriate (most air or digital machines are not worth using), taken standing instead of sitting or lying down, tight arm clothing, arm below instead of at level of heart, cuff (area put on arm) of the machine is not the right size (not covering arm properly), or the pressure is taken too quickly. Readings should be taken relaxed at least 15 minutes after waiting (seated). Also some patients may show high pressure in a hospital and none at home. This is called white coat hypertension (white coat refers to a doctor’s coat hence hospital setting). This is believed to be due to anxiety some get when at a clinic or hospital.

Most people with consistently high readings (140/90mmHg or above) will be treated especially if they have diabetes as well. Unfortunately, in Uganda people are treated for mild (140/90mmhg) at the index visit because of many reasons including failure to return for proper follow up.
Mild hypertension if not associated with blood fats or diabetes may only require lifestyle changes such as a healthier diet, less salt and alcohol, quitting smoking, and getting more physical exercise. If this does not help the doctor may advise mild treatment or closer monitoring.
Many Ugandans fear to reveal they are on treatment (whether they are aware or not) for fear of “victimisation” and hence may not get proper management being considered hypertensive in one place and normal in another.

EXPERTS SAY
Reading. Blood pressure readings are given as two numbers. The systolic blood pressure (top number) equals the pressure in the arteries as the heart contracts. The diastolic pressure (bottom number) is the pressure in the arteries as the heart relaxes. Normal blood pressure is below 120/80; between 120/80 and 139/89 is called “pre-hypertension,” and a blood pressure of 140/90 or above is considered high while a systolic blood pressure of about 90 to 100 is considered low blood pressure.