Hypertension need to make those inspections? What is the point?

The first differential diagnosis by examination:

People had elevated blood pressure, can be divided into primary hypertension and secondary hypertension, hypertensive disease as long as the antihypertensive drugs treatment of blood pressure control to can be a normal, while secondary hypertension disease many antihypertensive drug treatment is ineffective, the two treatment is not the same, so it must be identification to distinguish is that hypertension.

Hypertension patients to the hospital to do a lot of project examination, patients sometimes often do not understand. These checks are what meaning? The doctor has just found in the hypertensive patient, first is to confirm the patient enough hypertensive diagnostic criteria, it is to do 24 hours ambulatory blood pressure monitoring. Then is to find the analysis judgment caused by high blood pressure causes. Caused by high blood pressure causes a two class. In a genetic basis due to unhealthy lifestyle habits lead to human blood pressure regulation disorder and elevated blood pressure, hypertension and visceral primary without any substantial pathological changes, only the functional disorders, check liver function, renal function, and blood, urine and other all projects are normal, called the primary hypertension. Now all in the treatment of hypertension antihypertensive drugs are only in the treatment of primary hypertension, such patients about accounted for the vast majority of patients with hypertension, about 95% more.

Another human body involved in blood pressure regulation in the organ had parenchymal lesions, leading to hypertension is secondary hypertension. Reason involved throughout the body big, arterial stenosis, plug; renal function insufficiency; pituitary adenoma; thyroid function abnormalities in adrenal adenoma and pheochromocytoma,;. Such patients are in the minority, only 5%.

The doctor must first distinguish between these two kinds of disease, and then prescribe treatment, for secondary hypertension generally antihypertensive medications are ineffective, the examination project is mainly about several aspects: arterial function check is to see the body, there is no large artery stenosis and occlusion, due to stenosis of different parts, and performance as blood pressure abnormalities, such as high blood pressure and brachial blood pressure than in the lower extremities. Left and right sides of the blood pressure difference is too large. Whether or not the renal function insufficiency, edema ( creatinine, urea nitrogen do performance and protein in the urine examination ). Thyroid function abnormalities, is easily excited, heartbeat tachycardia; adrenal adenoma and pheochromocytoma; etc. (expressed as paroxysmal increased blood pressure, can recover ), pituitary adenoma, ( skin erythema, secondary sex characteristics abnormality). Need blood tests of renal function, thyroid hormone levels and renin, aldosterone, angiotensin, cortisol, catecholamines and so on those involved in blood pressure regulation of hormone. And make the kidney and adrenal gland of thin-section CT scan; and renal artery angiography and brain MRI to judge whether there is abnormal. If the suspected pheochromocytoma and general examination is difficult to determine the need for positron emission tomography, commonly known as: PET. These inspection requirements are very strict conditions, need to stop medicine hospitalization.

Second as a guide for drug inspection:

Treatment of hypertension to prevent cardiovascular and renal important human organ accident risk. For those suffering from chronic hypertensive patients should be checked by assessing the risk level degree. , some examination is to view the hypertension on human vascular injury degree of carotid artery ultrasound and do fundus film. But the cardio-cerebral vascular disease causes not only high blood pressure, and other factors, these factors are also associated with hypertension. These associated with cardiac and cerebral vascular disease with other risk factors, such as lipids, blood glucose. Homocysteine to assessment of hypertensive patients the occurrence of cardiovascular and cerebrovascular disease risk level.

Look at the hypertension on cardiac, brain, kidney and other target organs damage. Do cardiac ultrasound have myocardial hypertrophy electrocardiogram check, understand that there is no myocardial ischemia, brain CT or MRI understand that there is no cerebral vascular blockage. As well as assays on renal function and urine, urine protein in kidney injury represents. Do renal artery ultrasound to see whether a stenosis renal artery.

It is noted that, according to the doctor to determine treatment options. Once established treatment regimens, we must adhere to long-term use, shall not be easily interrupted.

Of course the above said these screening programs, and not everyone need to finish in one time, but by the doctor according to patient 's symptoms, and blood pressure levels, as well as drug treatment effect to gradually phase completed. Only a few serious three level in patients with essential hypertension treatment effect is not good when the introduced above all project hospital a check. For the majority of the newly discovered level in patients with essential hypertension is beginning to do heart liver and kidney function, blood glucose and lipids blood routine and electrocardiogram, arterial function in preliminary screening. After according to patient outcomes and clinical performance by the physician decides the next check items.