Diagnostic tests for hypertension

Diagnostic tests for hypertension

Primary hypertension is usually asymptomatic. Elevation in blood pressure after repeated measurement at a different interval is the most useful way to diagnose hypertension.

Diagnostics for secondary hypertension

Causes	Physical examination	Laboratory findings	Tests
Renal parenchymal disease	Mass in abdomen	Presence of protein, erythrocytes, or leucocytes in the urine Decreased Glomerular Filteration Rate	Renal ultrasound All laboratory tests related to kidney
Renal artery stenosis	Abnormal sound (bruit) in the abdomen	Difference of >1.5 cm in length between the two kidneys Decrease in renal function	Renal doppler ultrasound, Magnetic resonance angiography, Spiral computed tomography
Primary aldosteronism	Arrhythmias	Hypokalemia, presence of adrenal masses	Estimation of aldosterone and renin ratio, oral sodium loading, Captopril tests, Adrenal CT scan.
Pheochromocytoma	Skin stigmata of neurofibromatosis	presence of adrenal or extra-adrenal masses	CT or MRI of the pelvis, Genetic screening for pathogenic mutations
Cushing syndrome	central obesity, moon-face, buffalo hump, red striae, hirsutism	Hyperglycaemia	24-hr urinary cortisol excretion, Dexamethasone-suppression test

Other laboratory investigations for hypertension

• Haemoglobin
• Fasting blood glucose
• Cholesterol profile
• Fasting serum triglycerides
• Kidney function tests
• Estimated glomerular filtration rate
• Urine analysis test
• 12 lead EKG
• Hemoglobin A1c
• Quantitative proteinuria
• ECG
• Holter monitoring
• Carotid ultrasound
• Pulse wave velocity
• Ankle-brachial index
• Ambulatory BP monitoring

Complications of hypertension

If hypertension remains untreated, it can produce complications such as the following:

• Ventricular hypertrophy
• Heart failure
• Atherosclerosis
• Cerebrovascular disease
• Stroke
• Renal failure
• Retinopathy
• Chronic disease
• Difficulty in understanding and retention of memory
• Dementia
• Metabolic syndrome

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