Changes are classified (according to the Keith, Wagener, and Barker classification) into 4 groups with increasingly worse prognosis: Grade 1: Constriction of arterioles only Grade 2: Constriction and sclerosis of arterioles Grade 3: Hemorrhages and exudates in addition to vascular changes Grade 4: Papilledema Diagnosis of Hypertension Multiple measurements of BP to confirm Testing to diagnose causes and complications Hypertension is diagnosed by sphygmomanometry.