A series of studies and surveys conducted by National Health and Nutrition Examination Survey (NHANES) between 1976 and 2004 to assess the trends in hypertension prevalence, blood pressure distributions and mean levels, and hypertension awareness, treatment, and control among US adults, aged more than 18 years, showed that there is an increasing pattern of awareness, control and treatment of hypertension, and that prevalence of hypertension is increasing reaching 28.9% as of 2004, with the largest increases among non-hispanic women.[1]
Laboratory tests
editOnce the diagnosis of hypertension has been made it is important to attempt to exclude or identify reversible (secondary) causes. Secondary hypertension is more common in preadolescent children, with most cases caused by renal disease. Primary or essential hypertension is more common in adolescents and has multiple risk factors, including obesity and a family history of hypertension.[2] Tests are undertaken to identify possible causes of secondary hypertension, and seek evidence for end-organ damage to the heart itself or the eyes (retina) and kidneys. Diabetes and raised cholesterol levels being additional risk factors for the development of cardiovascular disease are also tested for as they will also require management. Such as follows:
| System | Tests |
|---|---|
| Renal | Microscopic urinalysis, proteinuria, serum BUN and/or creatinine |
| Endocrine | Serum sodium, potassium, calcium, TSH |
| Metabolic | Fasting blood glucose, total cholesterol, HDL and LDL cholesterol, triglycerides |
| Other | Hematocrit, electrocardiogram, and Chest X-ray |
| Sources: Harrison's principles of internal medicine[3] others[4] | |
Creatinine (renal function) test is done to identify both underlying renal disease as a cause of hypertension and conversely hypertension causing onset of kidney damage. Also a baseline for later monitoring the possible side-effects of certain antihypertensive drugs. And Glucose test is done to identify diabetes mellitus.Additionally testing of urine samples for proteinuria - again to pick up underlying kidney disease or evidence of hypertensive renal damage. And Electrocardiogram (EKG/ECG) test is done for evidence of the heart being under strain from working against a high blood pressure. Also may show resulting thickening of the heart muscle (left ventricular hypertrophy) or of the occurrence of previous silent cardiac disease (either subtle electrical conduction disruption or even a myocardial infarction). Chest X-ray might be used to observe signs of cardiac enlargement or evidence of cardiac failure.
To encourage everybody to focus their attention on hypertension, May 17, 2007, was designated as "World Hypertension Day." by the World Hypertension League organization which is a division of the International Society of Hypertension, and in an official relations with the World Health Organization (WHO)[5]
- ^ a b Burt VL, Cutler JA, Higgins M; et al. (July 1995). "Trends in the prevalence, awareness, treatment, and control of hypertension in the adult US population. Data from the health examination surveys, 1960 to 1991". Hypertension. 26 (1): 60–9. doi:10.1161/01.hyp.26.1.60. PMID 7607734. Retrieved 2009-06-05.
{{cite journal}}: Explicit use of et al. in:|author=(help)CS1 maint: date and year (link) CS1 maint: multiple names: authors list (link) - ^ Luma GB, Spiotta RT (may 2006). "Hypertension in children and adolescents". Am Fam Physician. 73 (9): 1558–68. PMID 16719248.
{{cite journal}}: Check date values in:|date=(help)CS1 maint: date and year (link) - ^ Loscalzo, Joseph; Fauci, Anthony S.; Braunwald, Eugene; Dennis L. Kasper; Hauser, Stephen L; Longo, Dan L. (2008). Harrison's principles of internal medicine. McGraw-Hill Medical. ISBN 978-0-07-147691-1.
{{cite book}}: CS1 maint: multiple names: authors list (link) - ^ Mulatero P, Bertello C, Verhovez A; et al. (June 2009). "Differential diagnosis of primary aldosteronism subtypes". Current Hypertension Reports. 11 (3): 217–23. doi:10.1007/s11906-009-0038-1. PMID 19442332.
{{cite journal}}: Explicit use of et al. in:|author=(help)CS1 maint: date and year (link) CS1 maint: multiple names: authors list (link) - ^ Jones DW, Hall JE (May 2007). "World Hypertension Day 2007". Hypertension. 49 (5): 939–40. doi:10.1161/HYPERTENSIONAHA.107.088740. PMID 17420339. Retrieved 2009-06-07.
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