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Evaluation of Hypertensive Patients for End-Organ Damage and Treatable Comorbidities

for Health Care Providers

Evaluation of Hypertensive Patients for End-Organ Damage and Treatable Comorbidities

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ComponentEvaluationPossible 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