- 1 WHAT IS IT?
- 2 WHAT CAUSES IT?
- 3 WHY IS IT A PROBLEM?
- 4 WHAT MAKES US SUSPECT IT?
- 5 CLINICAL WORKUP
- 6 AT WHAT POINT DO WE FEEL CONFIDENT IN MAKING THE DIAGNOSIS?
- 7 WHAT ELSE ARE WE WORRIED ABOUT?
- 8 HOW DO WE TREAT IT?
- 9 HOW WELL DO THE PATIENTS DO?
- 10 WAS THERE A WAY TO PREVENT IT?
- 11 OTHER FACTS?
- 12 FURTHER READING
WHAT IS IT?
Essential hypertension (also called idiopathic or primary hypertension) refers to a state of elevated blood pressures that do not have a discernible medical cause. Typically a blood pressure above 140/90 mmHg is considered to fall into the range of “hypertension”.
WHAT CAUSES IT?
By definition it is not clear what exactly causes essential hypertension in patients. That being said lifestyle factors (diet, activity level, stress levels, tobacco usage) are all likely contributory.
WHY IS IT A PROBLEM?
Hypertension increases the risk for heart disease and stroke in patients.
WHAT MAKES US SUSPECT IT?
Older age, African American race, obesity, tobacco usage, alcohol consumption.
- Generally asymptomatic
- Headache may be an uncommon complaint
History Of Present Illness
Life style factors: smoking, drinking, poor diet (high salt)
Physical Exam Findings
Vitals: by definition patient’s blood pressure will be evaluated (usually hypertension is defined as a pressure above 140/90 mmHg)
Basic Metabolic Profile (BMP): this study can provide evidence of the following disease processes.
- Kidney disease: obviously this is a very broad category (and can include many different disease processes) however one of the first signs of renal pathology can be an elevated creatine and a decreased glomerular filtration rate.
- Primary hyperaldosteronism can be suspected in patients with hypokalemia (in the setting of metabolic alkalosis).
Thyroid hormone studies (TSH):
- Hyperthyroidism can be responsible for causing hypertension.
- Hypothyroidism can also be responsible for causing hypertension (generally in older individuals).
AT WHAT POINT DO WE FEEL CONFIDENT IN MAKING THE DIAGNOSIS?
The diagnosis of hypertension should be based on ≥ 2 blood pressure measurements per visit on ≥ 2 visits.
WHAT ELSE ARE WE WORRIED ABOUT?
HOW DO WE TREAT IT?
HOW WELL DO THE PATIENTS DO?
WAS THERE A WAY TO PREVENT IT?
Page Updated: 09.28.2016