Hypertension Blood Test
Once diagnosed as hypertension, and then diagnose the reason behind the cause of hypertension.
Purpose of hypertension blood tests
Evaluation of hypertension patients has three objectives; they are:
- Diagnose or rule out a secondary cause of high blood pressure (such as renal artery stenosis, hyperaldosteronism, pheochromocytoma, coarctation of the aorta, cushings's syndrome, renal disease and coarctation of the aorta).
- Check whether the high blood pressure has caused target organ damage (such as Coronary heart disease, myocardial infarction, left ventricular hypertrophy, aortic aneurysm, peripheral vascular disease, retinopathy, hypertensive encephalopathy, chronic kidney failure, cerebral hemorrhage, stroke and heart failure).
- Check risk factors for cardiovascular diseases, such as a high-cholesterol level or high blood-glucose level (diabetes).
Obtain all this required information from your medical history, physical examination, laboratory investigations and other diagnostic procedures.
Hypertension Physical examination
Immediately, after hypertension diagnosis, your initial physical examination should include:
- Need to take three blood pressure measurements (ignore the first) on three separate occasions with the patient seated, back and arm supported.
- Measure BP in both arms, if the values are different, the higher value should use subsequently.
- Measures your height, weight and waist circumference; waist circumference provides necessary information regarding cardiovascular risk related to obesity.
- Examine for hypertensive retinopathy.
- Examine your neck for carotid bruits, distended veins or an enlarged thyroid gland.
- Heart examination for abnormalities in rate and rhythm, increased size, precordial heave, clicks, murmurs, and third & fourth heart sounds.
- Examine the lungs for rales (an abnormal crackling or rattling sound) and bronchospasm (spasmodic contraction of the smooth muscle of the bronchi, as in asthma).
- Examine the abdominal for bruits, enlarged kidneys, masses and abnormal aortic pulsation.
- Examine the extremities for diminished/absence of peripheral arterial pulsations, bruits and edema.
- Neurological examination
- Initial laboratory studies
Initial test hypertension
Initial lab tests should include:
- Use a 12-lead electrocardiogram to look for left ventricular hypertrophy (LVH), using voltage criteria.
- Urinalysis is to measure protein and blood levels in urine.
- Complete blood cell count
- Perform the random plasma glucose test, if elevated; do fasting blood glucose, OGTT, or A1C test?
- Measure the serum electrolyte levels - sodium, potassium, creatinine (test that measures kidney function), and calcium.
- Random lipid profile; it includes total cholesterol, HDL cholesterol, LDL cholesterol and triglycerides.
Additional tests will order based on clinical findings. These may include but are not limited to complete blood count, chest x-ray, uric acid and urine micro-albumin.