Chronic hypertension resident survival guide: Difference between revisions
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❑ [[Fundoscopy]] to diagnose retinopathy<br> | ❑ [[Fundoscopy]] to diagnose retinopathy<br> | ||
:❑ [[Hemorrrhage]] <br> | :❑ [[Hemorrrhage]] <br> | ||
:❑ [[Papilledema]]<br> | |||
:❑ [[Cotton wool spots]]<br> | :❑ [[Cotton wool spots]]<br> | ||
'''Neck'''<br> | '''Neck'''<br> | ||
❑ Carotid bruits (suggestive of )<br> | ❑ Carotid bruits (suggestive of )<br> | ||
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'''Abdominal examination'''<br> | '''Abdominal examination'''<br> | ||
❑ Bruits over abdominal aorta (suggestive of [[aortic aneurysm]])<br> | ❑ Bruits over abdominal aorta (suggestive of [[aortic aneurysm]])<br> | ||
❑ Bruits over renal artery (suggestive of [[renal artery stenosis]]) | ❑ Bruits over renal artery (suggestive of [[renal artery stenosis]])<br> | ||
❑ <br> | ❑ <br> | ||
'''Extremity examination'''<br> | '''Extremity examination'''<br> |
Revision as of 20:18, 16 April 2014
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Ayokunle Olubaniyi, M.B,B.S [2]
Overview
Classification
Classification | Blood pressure (mmHg) |
---|---|
Normal | < 120/80 |
Prehypertension | 120-139/80-89 |
Stage 1 hypertension | 140-159/90-99 |
Stage 2 hypertension | ≥ 160/110 |
Isolated systolic hypertension | |
Isolated diastolic hypertension |
Causes
Life Threatening Causes
Common Causes
Diagnosis
Shown below is an algorithm summarizing the diagnosis of
General Approach to Suspected Hypertension
Suspected hypertension BP > 140/90 mmHg | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Blood pressure measurement Before taking the BP
❑ Take 2 readings and find the average Click here for more information regarding blood pressure measurement | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Confirmed hypertension | Normotensive | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Classify the patient based on the BP reading | White-coat hypertension | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
SBP 120-139 mmHg DBP - 80-89 mmHg | SBP 149-159 mmHg DBP 90-99 mmHg | SBP >160 mmHg DBP >110 mmHg | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Prehypertension | Stage 1 hypertension Proceed to complete diagnostic approach | Stage 2 hypertension
Proceed to hypertensive crisis resident survival guide | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
{{{ }}} | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Treatment Lifestyle modification
❑ Adopt healthy diet
❑ Limit alcohol consumption
❑ Regular aerobic physical activity (brisk walking, jogging, cycling, swimming) for at least 30 mins per day ❑ | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Complete Diagnostic Approach
Obtain a detailed history: History of present hypertension
❑ Excessive sodium intake >2.4g per day ❑ Eyes:
❑ Cardiovascular:
❑ Kidneys:
| |||||||||||||||||||
Examine the patient: General examination: Neck
Respiratory examination Abdominal examination
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Order tests: Routine
❑ EKG Additional tests to diagnose specific etiologies: | |||||||||||||||||||
Does this patient have an identifiable secondary etiology? | |||||||||||||||||||
Yes | No | ||||||||||||||||||
Primary hypertension | Secondary hypertension | ||||||||||||||||||
Proceed to treatment | |||||||||||||||||||
Treatment
Shown below is an algorithm summarizing the treatment of