Hypertension, Essential

Alternate Name:

Test:

A pathological cause for hypertension should be excluded by selection from the following tests: U.M/C/S, Hb, B.urea, S.creatinine, &electrolytes, S.uric acid, B.cholesterol and triglycerides, B.glu­cose, ECG, renal ultrasound, IVP Additional tests if clinical suspicion of further pa­thology exists could include TFT, U.catechola­mines, U.renin, dexamethasone suppression test, insulin resistance, echocardiography

Sign:

Apex beat displacement, retinal arteriovenous nipping, exophthalmos (malignant), papilloedema, pulsus atternans, retinal exudates, retinal haemorrhages, Osier's phenomenon

Dd:

Pathological causes include renal disease, renal artery stenosis, Cushing syn., Conn syn., phaeochromocytoma, toxaemia of pregnancy, aortic coarctation, ovarian tumours, porphyria, subarachnoid haemorrhage, lead poisoning, hor­mone therapy

Phys:

Essential hypertension is high BP for which no pathological cause can be- found. A pressure of 160/100 mmHg is associated with a threefold risk of mortality under 65 years