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Hypertension Evaluation


Hypertension is defined as blood pressure greater than 140/90. There are two types: Benign Essential Hypertension and Secondary Hypertension. Once hypertension is diagnosed a thorough evaluation is indicated to discover possible causes of secondary hypertension. Identifying an underlying cause may lead to a definitive cure of the hypertension. The underlying cause may also be another major medical problem which could potentially be life threatening. Finally the evaluation could identify some damage already done by the high blood pressure, which might require immediate intervention or more aggressive treatment to prevent premature death or disability.

Hypertension is diagnosed by documenting the elevated pressure at random times over a period of several weeks. This can be done after checking the blood pressure at a series of 3-6 doctor’s visits. The other option is to check the blood pressures at home. The pressure should be checked at stress free times and at random times during the day to simulate normal life and if necessary 24 hour ambulatory monitoring can be done. The series of blood pressures can help the physician decide how to best manage the problem. If the blood pressure is in the pre-hypertension range or at Stage 1 then there is time to institute lifestyle changes. If the blood pressure is >160/100 then urgent treatment is required. This is described as hypertension urgency. Malignant hypertension exists when the blood pressure is in the severe range and has symptoms such as headaches and confusion. This usually requires admission to the hospital for immediate control.

Once hypertension is diagnosed then further evaluation is indicated. The goal is to determine the possible cause of the elevated blood pressure and the level of organ damage that may have been sustained prior to the diagnoses.

The evaluation should first consist of a thorough history and physical examination. The urine is analyzed for the presence of protein, which may indicate kidney damage. Blood work is also drawn to evaluate kidney function and to search for other medical problems such as diabetes and elevated cholesterol. An electrocardiogram (ECG) is done to evaluate the condition of the heart. It may reveal evidence of heart failure, abnormal rhythm or an unrecognized heart attack. Other test may include a detailed eye examination looking for damage to the retina. Other scans or special test maybe ordered to look for arterial aneurysms and kidney function.

Early detection and treatment of hypertension could save your life. It is important for every adult to have his or her blood pressure monitored on a regular basis. This is routinely done at all doctor’s visits. You should know what your blood pressure is and if it is higher than it should be then see your doctor follow his or her advice for further monitoring or evaluation. Hypertension can also be prevented in many by exercising on a regular basis and controlling your weight.

I hope this article has provided you with information that will help you make wise choices, so you may:

Live healthy, live well and live long!
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Understanding Hypertension
Epidemiology of Hypertension
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Content copyright © 2014 by Dr. Denise Howard. All rights reserved.
This content was written by Dr. Denise Howard. If you wish to use this content in any manner, you need written permission. Contact Dr. Denise Howard for details.

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