II. Goals
- Identify end organ damage
- Identify signs Secondary Hypertension
- Identify reversible exacerbating factors
- Document progression
III. Exam: Vitals
-
BP Examination
- See Blood Pressure Measurement
- Consider arm to leg systolic BP measurements (difference >20 mmHg suggests Aortic Coarctation)
- Hypertension Diagnosis
-
Pulses
- Bilateral radial pulse
- Assess for Obesity
- Weight and Height
- Ideal Body Weight or BMI
- Waist Circumference (assess for Metabolic Syndrome)
IV. Exam: Head
- Retinal Exam
-
Mouth Exam
- Mallampati Score increased in Sleep Apnea
V. Exam: Neck
- Thyroid exam
- Carotid Bruits
- Neck vein exam
VI. Exam: Chest
- Congestive Heart Failure signs
- Palpable intercostal pulses
VII. Exam: Cardiovascular
- S4 Gallop rhythm (decreased LV compliance)
- Tachycardia
- Accentuated S2 Heart Sound
- Aortic Insufficiency murmur
- Abnormal EKG or Echocardiogram
- Prior Angiography results
VIII. Exam: Abdomen
- Renal artery bruit
- May be present in Renal Artery Stenosis
- Abdominal Aortic Aneurysm
- Enlarged or tender Kidneys (CVA pain)
IX. Exam: Genitourinary
- Abnormal Sexual Development
- Enlarged Prostate
X. Exam: Peripheral Vascular Disease
- Femoral bruits
- Femoral pulses
- Delayed or absent in Aortic Coarctation
- Symmetrical pulses
- Lower extremity shin Hair Loss
XI. Exam: Neurologic
XII. Exam: Skin
- Stigmata of Cirrhosis
- Neurofibromata
- Chloasma
- Signs of Cushing's Disease
- Striae
- Acne Vulgaris
- Hirsutism
XIII. References
Images: Related links to external sites (from Bing)
Related Studies
| Definition (MEDLINEPLUS) |
Blood pressure is the force of your blood pushing against the walls of your arteries. Each time your heart beats, it pumps out blood into the arteries. Your blood pressure is highest when your heart beats, pumping the blood. This is called systolic pressure. When your heart is at rest, between beats, your blood pressure falls. This is the diastolic pressure. Your blood pressure reading uses these two numbers, the systolic and diastolic pressures. Usually they are written one above or before the other. A reading of
High blood pressure usually has no symptoms, but it can cause serious problems such as stroke, heart failure, heart attack and kidney failure. You can control high blood pressure through healthy lifestyle habits and taking medicines, if needed. NIH: National Heart, Lung, and Blood Institute |
| Definition (NCI_CDISC) | Pathological increase in blood pressure defined as one of the following: History of hypertension diagnosed and treated with medication, diet, and/or exercise; On at least 2 separate occasions, documented blood pressure greater than 140 mm Hg systolic and/or 90 mm Hg diastolic in patients without diabetes or chronic kidney disease, or blood pressure greater than 130 mm Hg systolic or 80 mm Hg diastolic in patients with diabetes or chronic kidney disease; Currently on pharmacological therapy for the treatment of hypertension. |
| Definition (NCI) | Blood pressure that is abnormally high. |
| Definition (NCI_CTCAE) | A disorder characterized by a pathological increase in blood pressure; a repeatedly elevation in the blood pressure exceeding 140 over 90 mm Hg. |
| Definition (NCI_NCI-GLOSS) | A blood pressure of 140/90 or higher. High blood pressure usually has no symptoms. It can harm the arteries and cause an increase in the risk of stroke, heart attack, kidney failure, and blindness. |
| Definition (CSP) | persistantly high arterial blood pressure. |
| Definition (MSH) | Persistently high systemic arterial BLOOD PRESSURE. Based on multiple readings (BLOOD PRESSURE DETERMINATION), hypertension is currently defined as when SYSTOLIC PRESSURE is consistently greater than 140 mm Hg or when DIASTOLIC PRESSURE is consistently 90 mm Hg or more. |
| Concepts | Disease or Syndrome (T047) |
| MSH | D006973 |
| ICD9 | 997.91, 401-405.99 |
| ICD10 | I10-I15.9 , I10, I10-I15 |
| SnomedCT | 38341003, 155302005, 194757006, 194760004, 155295004, 194756002, 266287006, 194794002, 195537001 |
| LNC | MTHU020789, LA14293-7, LA7444-8 |
| English | Hypertension, BLOOD PRESSURE HIGH, HYPERTENSION ARTERIAL, Hypertensive disease NOS, Hypertensive diseases, [X]Hypertensive diseases, Systemic hypertension, Hypertensive disorder, systemic arterial, hyperpiesia, hyperpiesis, systemic HTN, systemic hypertension (diagnosis), systemic hypertension, Hypertension arterial, Blood pressure high, HBP, HT, Hypertension NOS, Surg comp - hypertension, HTN, Hypertension [Disease/Finding], high blood pressure, hypertensive disorder, hypertensive vascular disease, arterial hypertension, arterial hypertension systemic, vascular hypertension, blood high pressure, high blood pressure disorder, systemic arterial hypertension, hypertensive disease, Hypertensive diseases (I10-I15), Complications affecting other specified body systems, not elsewhere classified, hypertension, High Blood Pressure, Hypertensive disease NOS (disorder), Hypertensive disease (disorder), (Hypertensive disease) or (hypertension), (Hypertensive disease) or (hypertension) (disorder), [X]Hypertensive diseases (disorder), hypertension, BLOOD PRESSURE, INCREASED, BLOOD PRESSURE, HIGH, Hypertensive Disorder, HIGH BLOOD PRESSURE, INCREASED BLOOD PRESSURE, HYPERTENSION, PRESSURE, HIGH BLOOD, High blood pressure, Hyperpiesia, Hyperpiesis, Hypertensive vascular degeneration, Hypertensive vascular disease, BP - High blood pressure, High blood pressure disorder, Systemic arterial hypertension, HBP - High blood pressure, BP+ - Hypertension, HT - Hypertension, Hypertensive disorder, systemic arterial (disorder), Hypertensive disorder, HTN - Hypertension, blood pressure; high, high; arterial tension, high; blood pressure, Hypertension, NOS, Hypertensive disease, NOS, Raised blood pressure (disorder), Blood Pressure, High, Blood Pressures, High, High Blood Pressures, Vascular Hypertensive Disorder, Hypertensive disease, HYPERTENSIVE DISEASE |
| French | HYPERTENSION ARTERIELLE, Pression artérielle élevée, PAH, Hypertension SAI, TH, HYPERTENSION, TENSION ARTERIELLE E, Hypertension chronique, Hypertension permanente, Hypertension artérielle, Hypertension |
| Portuguese | HIPERTENSAO, Hipertensão arterial NE, Hipertensão arterial, Pressão arterial alta, HYPERTENSAO ARTERIAL, PRESSAO SANGUINEA ELEVADA, Pressão Arterial Alta, Pressão Sanguínea Alta, Hipertensão |
| Spanish | HIPERTENSION, PRESION SANGUINEA ALTA, Presión sanguínea alta, HTA, Hipertensión NEOM, Hipertensión arterial, HT, HIPERTENSION ARTERIAL, enfermedad hipertensiva, SAI, [X]enfermedades hipertensivas (trastorno), enfermedad hipertensiva, SAI (trastorno), [X]enfermedades hipertensivas, Hypertensive disease NOS, degeneración vascular hipertensiva, enfermedad hipertensiva, enfermedad vascular hipertensiva, hiperpiesia, hiperpiesis, hipertensión arterial (trastorno), hipertensión arterial, presión arterial alta, tensión arterial alta, tensión arterial elevada, Hipertensión, Presión Sanguínea Alta |
| German | HYPERTONIE, Hypertonie, arteriell, Blutdruck, hoch, HBP, HT, Hypertonie NNB, BLUTDRUCK HOCH, HYPERTONIE ARTERIELL, Hypertension, Hypertonie |
| Dutch | hypertensie NAO, hoge bloeddruk, arteriële hypertensie, bloeddruk; hoog, hoog; arteriële druk, hoog; bloeddruk, hypertensie, Bloeddruk, hoge, Hypertensie |
| Italian | Ipertensione (HT), Ipertensione NAS, Pressione del sangue elevata, Ipertensione, Pressione sanguigna alta, Ipertensione arteriosa |
| Japanese | 動脈性高血圧, 高血圧ＮＯＳ, ｺｳｹﾂｱﾂ, ｺｳｹﾂｱﾂNOS, ﾄﾞｳﾐｬｸｾｲｺｳｹﾂｱﾂ, 高血圧, 高血圧症 |
| Swedish | Högt blodtryck |
| Czech | hypertenze, Arteriální hypertenze, Vysoký krevní tlak, Hypertenze NOS, Hypertenze, vysoký krevní tlak, hypertonie |
| Finnish | Kohonnut verenpaine |
| Russian | GIPERTENZIIA, GIPERTONICHESKAIA BOLEZN', KROVIANOE DAVLENIE VYSOKOE, ГИПЕРТЕНЗИЯ, ГИПЕРТОНИЧЕСКАЯ БОЛЕЗНЬ, КРОВЯНОЕ ДАВЛЕНИЕ ВЫСОКОЕ |
| Croatian | HIPERTENZIJA |
| Polish | Nadciśnienie |
| Hungarian | Arteriás hypertonia, Hypertensio, HT, RR magas, Hypertonia k.m.n., Magas vérnyomás |
| Norwegian | Høyt blodtrykk, Hypertensjon, Hypertoni |
