• See Also
  1. Hypertension
  2. Hypertension Causes
  3. Hypertension Evaluation
  4. Hypertension Evaluation History
  5. Hypertension Evaluation Labs
  6. Isolated Systolic Hypertension
  7. Hypertension Management
  8. Hypertension Risk Stratification
  9. Resistant Hypertension
  10. Antihypertensive Selection
  11. Hypertension Management for Specific Comorbid Diseases
  12. Hypertension Management for Specific Populations
  13. Hypertension Management for Specific Emergencies
  14. Hypertension in Children
  15. Hypertension in Infants
  16. Hypertension in Pregnancy
  17. Hypertension in Athletes
  18. Hypertension in the Elderly
  • Goals
  1. Identify end organ damage
  2. Identify signs Secondary Hypertension
  3. Identify reversible exacerbating factors
  4. Document progression
  • Exam
  • Vitals
  1. BP Examination
    1. See Blood Pressure Measurement
    2. Consider arm to leg systolic BP measurements (difference >20 mmHg suggests Aortic Coarctation)
    3. Hypertension Diagnosis
      1. See Hypertension Evaluation
      2. See Blood Pressure
      3. See Hypertension Criteria
      4. See Ambulatory Blood Pressure Monitoring
      5. See Home Blood Pressure Monitor
  2. Pulses
    1. Bilateral radial pulse
  3. Assess for Obesity
    1. Weight and Height
    2. Ideal Body Weight or BMI
    3. Waist Circumference (assess for Metabolic Syndrome)
  • Exam
  • Head
  1. Retinal Exam
    1. See Funduscopic Changes in Hypertension
  2. Mouth Exam
    1. Mallampati Score increased in Sleep Apnea
  • Exam
  • Neck
  1. Thyroid exam
  2. Carotid Bruits
  3. Neck vein exam
  1. Congestive Heart Failure signs
  2. Palpable intercostal pulses
  • Exam
  • Cardiovascular
  1. S4 Gallop rhythm (decreased LV compliance)
  2. Tachycardia
  3. Accentuated S2 Heart Sound
  4. Aortic Insufficiency murmur
  5. Abnormal EKG or Echocardiogram
  6. Prior Angiography results
  1. Renal artery bruit
    1. May be present in Renal Artery Stenosis
  2. Abdominal Aortic Aneurysm
  3. Enlarged or tender Kidneys (CVA pain)
  • Exam
  • Genitourinary
  1. Abnormal Sexual Development
  2. Enlarged Prostate
  1. Femoral bruits
  2. Femoral pulses
    1. Delayed or absent in Aortic Coarctation
  3. Symmetrical pulses
  4. Lower extremity shin Hair Loss
  • Exam
  • Neurologic
  1. Peripheral Neuropathy
  • Exam
  • Skin
  1. Stigmata of Cirrhosis
  2. Neurofibromata
  3. Chloasma
  4. Signs of Cushing's Disease
    1. Striae
    2. Acne Vulgaris
    3. Hirsutism
  • References
  1. Charles (2017) Am Fam Physician 96(7): 453-61 [PubMed]