Physical Examination for Complications of Hypertension
December 12, 2008 by rainier
If blood pressure is elevated, the physician will check the patient’s pulse rate, examine the neck for distended veins or an enlarged thyroid gland, check the heart for enlargement and murmurs, and examine the abdomen and the eyes.
Medical History
If hypertension is suspected, the physician should obtain the following information:
.A family and personal medical history, especially incidence of high blood pressure, stroke, heart problems,kidney disease, or diabetes.
·Risk factors of heart disease and stroke, including tobacco use, salt intake, obesity, physical inactivity, and unhealthy cholesterol levels.
· Any medications being taken.
.Any symptom that might indicate so−called secondary hypertension (that is, caused by another disorder). Such symptoms include headache, heart palpitations, excessive sweating, muscle cramps or weakness, or excessive urination.
· Any emotional or environmental factors that could affect blood pressure.
Laboratory and Other Tests
If a physical examination indicates hypertension, additional tests may help determine whether it is secondary hypertension or essential hypertension (no other disorder is present) and whether organ damage is present. They include the following:
Blood tests and a urinalysis. (Performed to check for a number of factors, including potassium levels,cholesterol, blood sugar, infection, kidney function, and other possible problems. Measuring blood levels of the protein creatinine, for example, is important for all hypertensive patients in order to determine kidney damage. Higher concentrations may also be an indicator of heart disease.)
· An electrocardiogram (ECG).
.An exercise stress test. This could be important for those with borderline hypertension. Stress−induced blood pressure in such patients has been associated with a risk for left ventricular hypertrophy, a serious complication in which the muscles on the left side of the heart become enlarged. Studies also suggest that an excessive rise in systolic pressure during exercise indicates a risk for coronary artery disease, and stroke.
