Chronic hypertension laboratory findings
|
Hypertension Main page |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Assistant Editor-In-Chief: Taylor Palmieri
Overview
Laboratory studies are often undertaken to identify possible causes of secondary hypertension, and seek evidence for end-organ damage to the heart itself or the eyes (retina) and kidneys. 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 Findings
Blood tests commonly performed include:
- Creatinine (renal function) - 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
- Cholesterol
- Urinalysis. Testing of urine samples for proteinuria - again to pick up underlying kidney disease or evidence of hypertensive renal damage.
- Glucose
- Blood urea nitrogen (BUN) / creatinine
- Basic metabolic panel
- Calcium
- Lipids
- Urinary albumin
- Glomerular filtration rate
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.