Rapid Workup Of Hypertension

OVERVIEW

This page is meant to provide a quick reference to a practical “work-up” of hypertension. Often patients may present with elevated blood pressures (> 140/90 mm Hg) however the cause may require some investigation.

Elevated blood pressure can be a very common finding clinically. It is for this reason that one must be skilled in the art of rapidly working it up! (source)

IMPORTANT POINTS TO COVER IN THE HISTORY

While it can be impossible to DEFINITIVELY prove that hypertension is caused by a specific lifestyle choice there are a few important aspects of a patient’s history that can very likely contribute to an elevated blood pressure.

Ones lifestyle choices really can have an impact on blood pressure. It is worth exploring these topics as a physician in patients who have hypertension (source)

Diet: it is easy to overlook this element of a patient. There are a few dietary habits that have been thought to be associated with an increased blood pressure.

High salt intake
Excessive alcohol consumption

Lack of exercise:

Smoking:

SERUM CLINICAL STUDIES: CLUES ON CAUSES OF HYPERTENSION

Basic Metabolic Panel (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).

Page Updated: 09.07.2016