11 Steps to Diagnosing hypertension

Hypertension can be properly diagnosed by carrying out detailed medical/laboratory investigations on the patient. The following the under-listed 12 steps can really be of great help in trying to establish whether or not an individual has hypertension:
1.Detailed health history of the patient should be obtained. Information such as the lifestyle, economic status and past medical history should be obtained so as to get a clue as to the probable type of hypertension, or any condition that is responsible for secondary hypertension.
2.Physical examination (palpation) to detect any signs of adrenal mass or cardiac enlargement. The radial and femoral pulses should also be palpated to determine the rate and quality. Blood pressure readings should be obtained from both arms and legs while the patient is in supine position.
Other forms of investigations to detect secondary hypertension include:
3.Urinalysis: To detect epithelial cell cast: this is indicative of chronic glomerular lesions. Presence of pus cells also suggests the presence of proteinuria (presence of protein in urine) or pyelonephritis.
4.Blood Urea Nitrogen (BUN) and creatinine clearance tests should be carried out to ascertain renal dysfunction. An elevation of BUN and creatinine is indicative of renal problem which may have secondarily elevated the blood pressure.
5.Serum electrolytes evaluation may be done to detect the presence of primary aldosteronism, hypercalcaemia, hyperkalaemia and chronic renal disease.
6.Intravenous Pyelogram: This is a procedure whereby an x-ray of the renal system is carried out following the intravenous injection of a radio-opaque dye, in order to check the status of the kidneys.This could help in arriving at a proper diagnoses of secondary hypertension since renal disease is known to be a contributory factor.
7.Renin assays: Helps to evaluate the level of renin in the blood stream. The enzyme is usually released into the blood stream when there is ischaemia of the kidneys. This enzyme causes vasoconstriction and eventually leads to hypertension in the long run or worsen an already existing hypertension.
8.Urinary steroid excretion: An increase in the urinary steroid excretion shows a link between the steroid production and secondary hypertension.
9.Serum thyroxine: This may give clue to the presence of hyperthyroidism which is also one of the causes of secondary hypertension.
10.Plasma cholesterol/triglycerides: This also helps to establish the link between plasma cholesterol level and artheriosclerosis which is contributory to the development of secondary hypertension
11.ECG (to detect left ventricular hypertrophy: This will help to determine whether or not there already an enlargement of the left ventricle of the heart, which one of the major complications of hypertension.