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GUIDELINES FOR EVALUATING HYPERTENSION.

In recent years, new treatments and diagnostic technologies have been developed for hypertension, and the condition has been redefined as blood pressure greater than 140/90 mm Hg. Accordingly, the American Heart Association's Council for High Blood Pressure Research has reassessed the objectives for office evaluation of the hypertensive patient. These guidelines emphasize both efficiency and efficacy in detecting the secondary causes of hypertension and hypertension's complications.

The aim of the basic examination should be to measure damage to target organs and assess prognosis, to identify other risk factors for atherosclerosis, to assess general health, to detect secondary (possibly curable) causes of hypertension, and to determine whether hypertension is persistent. The evaluation should include a history, a complete physical examination, urinalysis, blood biochemistry analysis (serum creatinine, glucose, high- density-lipoprotein and total cholesterol, and potassium), a complete blood count, and an ECG. Blood-pressure measurements and ophthalmoscopic examinations should be repeated to assess the persistence of hypertension. These recommendations should be sufficient to assess prognosis in most patients and to detect secondary causes in the minority of patients with curable forms of hypertension.

— THL

Published in Journal Watch General Medicine March 21, 1989

Citation(s):

Gifford RW Jr et al. Office evaluation of hypertension: a statement for health professionals by a writing group of the Council for High Blood Pressure Research, American Heart Association. Circulation 1989 Mar 79 721-731.

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