Htn

Hypertension Evaluation History

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Hypertension Evaluation History

  • History
  • Past Medical History
  1. Severity of Hypertension with Blood Pressure log
  2. Onset of Hypertension
    1. Age <12: Associated with Secondary Hypertension in >70% of cases
    2. Age 12-18: Associated with Secondary Hypertension in 10-15% of cases
    3. Age 19-39: Associated with Secondary Hypertension in 5% of cases
    4. Age 40-64: Associated with Secondary Hypertension in 8-12% of cases
    5. Age >65: Associated with Secondary Hypertension in 17% of cases
    6. Viera (2010) Am Fam Physician 82(12): 1471-8 [PubMed]
  • History
  • Medications
  • History
  • Habits
  1. Salt intake
  2. Fat intake
  3. High Caloric Intake contributing to Obesity
  4. Alcohol use
  5. Tobacco Use
  6. Recreational Drugs of Abuse (stimulants)
    1. Cocaine
    2. Methamphetamine
  • History
  • Lead Exposure Risk
  1. Lead paints
  2. Printer inks
  3. Inhalation risks
  4. Postmenopausal women
    1. Lead increases due to skeletal lead mobilization
    2. Nash (2003) JAMA 289:1523-32 [PubMed]
  • Findings
  • Evidence of Endocrine Disease
  • Findings
  • Evidence of Renal Disease
  1. Renal Artery Stenosis (renovascular disease)
    1. Serum Creatinine increases 50% or more over baseline after starting ACE Inhibitor or ARB
    2. Unilateral small Kidney on Ultrasound
    3. Recurrent flash pulmonary edema
  2. Renal Disease
    1. Serum Creatinine increased
    2. Proteinuria
  • Findings
  • Evidence of Neurologic Disease
  1. Previous Neurologic disease or symptoms
  2. Headaches
  3. Confusion
  4. Seizures
  • Findings
  • Evidence of Sleep Disorder
  1. Loud snoring
  2. Daytime Somnolence
  3. Witnessed apneas
  4. May be associated with Headache, Fatigue, difficult concentration