Evaluation of Hypertensive Patients for End-Organ Damage and Treatable Comorbidities
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| Component | Evaluation | Possible Findings |
|---|
| History | - Review of systems
- Past medical history
- Health-related behavior
- Family history
| - Dyspnea, chest pain, edema, polyuria/polydipsia
- CAD, CHF, diabetes, renal disease
- Tobacco use, physical activity
- Early CAD, diabetes
|
| Physical examination | - Vital signs
- Ophthalmologic examination
- Peripheral circulation
- Cardiac examination
- Respiratory examination
| - Elevated BMI
- Arteriovenous nicking, papilledema (hypertensive retinopathy)
- Diabetic retinopathy
- Bruits: carotid, abdominal, or femoral (peripheral vascular disease)
- Decreased peripheral pulses
- LVH, S3, S4, distended neck veins (hypertrophy, failure)
- Crackles/wheezes
|
| Studies | - Electrolytes, BUN, Cr, glucose, Ca2+
- Fasting lipids
- Urinalysis
- ECG
- Spot urine protein/Cr ratio
| - Decreased renal function, diabetes, hyperaldosteronism
- Hyperlipidemia
- Proteinuria, glycosuria, hematuria
- LVH, CAD
|
From Hypertension
Primary Care of Veterans with HIV
Office of Clinical Public Health Programs
Veterans Health Administration, 2009
