Hypertensive patients should make the following examination items:
(1) Urine examination can help determine kidney function and understand whether hypertension is caused by kidney disease. Urine tests include urinary protein, urinary sediment count, and bacteriological examinations. It plays an important role in the diagnosis and differential diagnosis of hypertension. In most cases of essential hypertension without complications, urinary examination can be no significant change, but in the event of renal damage in essential hypertension, urine tests can show varying degrees of change: malignant hypertension can have A large number of proteinuria, hematuria, leukocytes and granular cast; renal essential hypertension, such as glomerular nephritis caused by hypertension, but also a corresponding change.
(2) Routine blood tests often have anemia in patients with renal parenchymal hypertension, whereas patients with essential hypertension do not generally have anemia.
(3) Blood biochemical tests include total blood protein, albumin, cholesterol, blood glucose, urea nitrogen, creatinine, sodium, potassium, chloride, calcium, magnesium, uric acid, and aspartate aminotransferase. If a hypertensive patient has lower than normal potassium in the blood without diuretics, primary or secondary hyperaldosteronism should be suspected. Serum creatinine is not affected by food and therefore is more reliable than urea nitrogen in assessing renal function. In patients with adrenal hypertension, pheochromocytoma, or long-term use of diuretics, the uric acid level in the blood may increase.
(4) Serological tests including C-reactive protein, anti-streptolysin "O", etc., have a certain reference value in the active period of constrictive arteritis.
(5) Chest X-ray examination is used to understand whether the heart is enlarged and expanded, and to know whether the blood vessels associated with the heart have variations, such as whether the aortic arch has prominence and extension of the aortic wall, whether the aortic wall has calcification and whether there is a dissection artery. Tumor; clear lung with or without congestion and pleural effusion. These are all related to the complications of hypertension.
(6) Electrocardiogram examination should pay attention to whether the high voltage of QRS wave caused by hypertensive left ventricular hypertrophy, QRS wave widening, ST segment decline and T wave hypoploid or inversion.
(7) Renal and renal function tests are mainly to understand whether there is any change in the morphology and function of the kidneys, including examination of morphology and function. The more commonly used ones are: 1 Intravenous pyelography, which is a safe and simple method of examination. It is a measure that must be taken when there is a suspected kidney abnormality, urethral obstruction, and renal vascular disease. 2 isotope nephrogram, renal scintigraphy examination, renal hypertension, especially for unilateral renal or renal vascular lesions in the diagnosis of greater value. 3 phenol red excretion test, creatinine clearance, etc. are used to evaluate whether the abnormal renal function check method.
(8) Determination of plasma renin activity is mainly used for the differential diagnosis of hypertension and secondary hypertension.
(9) Thyroid function tests include thyroid iodine uptake, serum total thyroxine levels, triiodothyronine levels, and serum thyrotropin levels.
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