Chronic hypertension laboratory findings: Difference between revisions
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==Overview== | ==Overview== | ||
Patients identified to be hypertensive must have an initial work-up to identify the presence and extent of target organ damage. Initial work-up is important because it recognizes initial baseline values that can aid the patient and the healthcare provider in assessing the evolution of hypertension and its complications with follow-up visits and lab tests. A more extensive work-up is only indicated when hypertension is not controlled with appropriate therapy or initial laboratory testing suggests a specific etiology of secondary hypertension. [[Diabetes]] and raised [[cholesterol]] levels being additional risk factors for the development of cardiovascular disease are also tested for as they will also require management. | |||
==Laboratory Tests== | |||
==Laboratory | |||
[[Blood test]]s commonly performed include: | [[Blood test]]s commonly performed include: | ||
* [[Creatinine]] | * [[Creatinine]] to assess [[GFR]]: to identify both underlying renal disease as a cause of hypertension and conversely hypertension causing onset of kidney damage. Also a baseline for later monitoring the possible side-effects of certain antihypertensive drugs. | ||
* [[Electrolyte]]s ([[sodium]], [[potassium]]) | * [[Electrolyte]]s ([[sodium]], [[potassium]]) | ||
* [[Glucose]] | * [[Glucose]]: to identify [[diabetes mellitus]] | ||
* [[ | * [[Lipid]] panel: Total [[cholesterol]], [[LDL]], [[HDL]] and [[triglycerides]] | ||
* [[Glucose]] | * [[Glucose]] | ||
* [[Blood urea nitrogen]] ([[BUN]]) / [[creatinine]] | * [[Blood urea nitrogen]] ([[BUN]]) / [[creatinine]] | ||
* [[Calcium]] | * [[Calcium]] | ||
* [[ | * [[Urinalysis]] | ||
* Urinary [[albumin]] | ** Urinary [[albumin]] excretion | ||
* | ** Albumin/Creatine ratio | ||
===Diagnostic Tests for Secondary Hypertension=== | ===Diagnostic Tests for Secondary Hypertension=== | ||
Revision as of 21:09, 9 March 2013
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Hypertension Main page |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Assistant Editor-In-Chief: Taylor Palmieri
Overview
Patients identified to be hypertensive must have an initial work-up to identify the presence and extent of target organ damage. Initial work-up is important because it recognizes initial baseline values that can aid the patient and the healthcare provider in assessing the evolution of hypertension and its complications with follow-up visits and lab tests. A more extensive work-up is only indicated when hypertension is not controlled with appropriate therapy or initial laboratory testing suggests a specific etiology of secondary hypertension. Diabetes and raised cholesterol levels being additional risk factors for the development of cardiovascular disease are also tested for as they will also require management.
Laboratory Tests
Blood tests commonly performed include:
- Creatinine to assess GFR: to identify both underlying renal disease as a cause of hypertension and conversely hypertension causing onset of kidney damage. Also a baseline for later monitoring the possible side-effects of certain antihypertensive drugs.
- Electrolytes (sodium, potassium)
- Glucose: to identify diabetes mellitus
- Lipid panel: Total cholesterol, LDL, HDL and triglycerides
- Glucose
- Blood urea nitrogen (BUN) / creatinine
- Calcium
- Urinalysis
- Urinary albumin excretion
- Albumin/Creatine ratio
Diagnostic Tests for Secondary Hypertension
Below is a table summarizing the diagnostic tests used in the case of secondary hypertension:[1]
| Diagnosis | Diagnostic Tests |
| Chronic kidney disease | Estimate GFR |
| Coarctation of aorta | CT angiography |
| Cushing's syndrome and other glucocorticoid excess states including chronic steroid therapy | History; dexamethasone suppression test |
| Drug induced/related | History; drug screening |
| Pheochromocytoma | 24 hour urinary metanephrine and normetanephrine |
| Primary aldosteronism and other mineralocorticoid 24-hour urinary aldosterone level or excess states | 24-hour urinary aldosterone level or specific measurements of other mineralocorticoids |
| Renovascular hypertension | Doppler flow study; magnetic resonance angiography |
| Sleep apnea | Sleep study with O2 saturation |
| Thyroid/ Parathyroid disease | TSH; serum PTH |
References
- ↑ Chobanian AV, Bakris GL, Black HR, Cushman WC, Green LA, Izzo JL; et al. (2003). "The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure: the JNC 7 report". JAMA. 289 (19): 2560–72. doi:10.1001/jama.289.19.2560. PMID 12748199.