Hypertension in general practice. Part I. Examination and investigation of a patient with hypertension.
During the history taking and physical examination, several important diseases should be searched for before diagnosing essential hypertension. A critical investigation is repetitive abdominal auscultation for a bruit. In young patients with significant hypertension, coarctation of the aorta must be excluded by clinical examination. Investigations will especially be aimed at uncovering renal artery disease (relatively common) or a phaechromocytoma (relatively rare). The initial assessment must also diagnose associated diseases which will influence the type of therapy chose. Thus asthma and heart failure contraindicate beta-blockers, liver disease contraindicates methyldopa, severe depression contraindicates reserpine, methyldopa and beta-blockade, while diabetes or gout may be precipitated or aggravated by thiazide diuretics.
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D001794:Blood Pressure; D005260:Female; D006801:Humans; D006973:Hypertension / Q000097:blood / Q000175:diagnosis* / Q000503:physiopathology / Q000652:urine; D007668:Kidney / Q000000981:diagnostic imaging; D008297:Male; D008487:Medical History Taking; D008875:Middle Aged; D010808:Physical Examination / Q000379:methods; D011859:Radiography; D012737:Sex Factors