• See Also
  1. Hypertension
  2. Hypertension Causes
  3. Hypertension Evaluation
  4. Evaluation Exam
  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
  • History
  • Past Medical History
  1. Severity of Hypertension with Blood Pressure log
  2. Onset of Hypertension
    1. Age <12: Associated with Secondary Hypertension in >70% of cases
    2. Age 12-18: Associated with Secondary Hypertension in 10-15% of cases
    3. Age 19-39: Associated with Secondary Hypertension in 5% of cases
    4. Age 40-64: Associated with Secondary Hypertension in 8-12% of cases
    5. Age >65: Associated with Secondary Hypertension in 17% of cases
    6. Viera (2010) Am Fam Physician 82(12): 1471-8 [PubMed]
  1. Hypertension
  2. Kidney disease
  • History
  • Medications
  1. See Medication Causes of Hypertension
  • History
  • Habits
  1. Salt intake
  2. Fat intake
  3. High Caloric Intake contributing to Obesity
  4. Alcohol use
  5. Tobacco Use
  6. Recreational Drugs of Abuse (stimulants)
    1. Cocaine
    2. Methamphetamine
  • History
  • Lead Exposure Risk
  1. Lead paints
  2. Printer inks
  3. Inhalation risks
  4. Postmenopausal women
    1. Lead increases due to skeletal lead mobilization
    2. Nash (2003) JAMA 289:1523-32 [PubMed]
  • History
  • Symptoms of Urinary tract Disease
  1. Urinary Tract Infection
  2. Nephrolithiasis (or Hypercalcemia)
  3. Benign Prostatic Hypertrophy
  • Findings
  • Evidence of Endocrine Disease
  1. Diabetes Mellitus
  2. Hyperthyroidism
  3. Hypothyroidism
  4. Hyperparathyroidism (Hypercalcemia)
    1. Confusion
    2. Major Depression
    3. Abdominal Pain
    4. Nephrolithiasis
    5. Constipation
  5. Cushing's Disease
    1. Acne Vulgaris
    2. Osteoporosis
    3. Bone Fractures
    4. Glucose Intolerance
  6. Aldosteronism
    1. Hypokalemia
    2. Muscle Weakness
    3. Paresthesias
    4. Tetany
  7. 11-Hydroxylase deficiency
    1. Premature Virilization in males
    2. Masculinization in females
  8. 17-Hydroxylase deficiency
    1. Failed sex maturation
  9. Pheochromocytoma
    1. Flushing
    2. Sweating
    3. Tremor
    4. Panic
    5. Facial pallor
    6. Headache
    7. Weight loss
    8. Labile Blood Pressure
    9. Orthostatic Hypotension
    10. Palpitations
    11. Syncope
  • Findings
  • Evidence of Renal Disease
  1. Renal Artery Stenosis (renovascular disease)
    1. Serum Creatinine increases 50% or more over baseline after starting ACE Inhibitor or ARB
    2. Unilateral small Kidney on Ultrasound
    3. Recurrent flash Pulmonary Edema
  2. Renal Disease
    1. Serum Creatinine increased
    2. Proteinuria
  • Findings
  • Evidence of Neurologic Disease
  1. Previous Neurologic disease or symptoms
  2. Headaches
  3. Confusion
  4. Seizures
  • Findings
  • Evidence of Cardiovascular disease
  1. Coronary Artery Disease
  2. Congestive Heart Failure
  3. Amaurosis Fugax
  4. Claudication
  5. Renal Artery Stenosis
  • Findings
  • Evidence of Sleep Disorder
  1. Loud snoring
  2. Daytime Somnolence
  3. Witnessed apneas
  4. May be associated with Headache, Fatigue, difficult concentration
  • References
  1. Charles (2017) Am Fam Physician 96(7): 453-61 [PubMed]