Cardiovascular Medicine Book

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Hypertension Evaluation Exam

Aka: Hypertension Evaluation Exam
  1. Goals
    1. Identify end organ damage
    2. Identify signs secondary Hypertension
    3. Identify reversible exacerbating factors
    4. Document progression
  2. Exam: Vitals
    1. BP Examination
      1. Consider arm to leg systolic BP measurements (difference >20 mmHg suggests Aortic Coarctation)
    2. Pulse
    3. Assess for Obesity
      1. Weight and Height
      2. Ideal body weight or BMI
      3. Waist Circumference (assess for Metabolic Syndrome)
  3. Exam: Head
    1. Retinal Exam
      1. See Funduscopic Changes in Hypertension
    2. Mouth Exam
      1. Mallampati Score increased in Sleep Apnea
  4. Exam: Neck
    1. Thyroid exam
    2. Carotid Bruits
    3. Neck vein exam
  5. Exam: Chest
    1. Congestive Heart Failure signs
    2. Palpable intercostal pulses
  6. Exam: Cardiovascular
    1. S4 Gallop rhythm (decreased LV compliance)
    2. Tachycardia
    3. Accentuated S2 Heart Sound
    4. Aortic Insufficiency murmur
    5. Abnormal EKG or Echocardiogram
    6. Prior Angiography results
  7. Exam: Abdomen
    1. Renal artery bruit
      1. May be present in Renal Artery Stenosis
    2. Abdominal Aortic Aneurysm
    3. Enlarged or tender Kidneys (CVA pain)
  8. Exam: Genitourinary
    1. Abnormal Sexual Development
    2. Enlarged Prostate
  9. Exam: Peripheral Vascular Disease
    1. Femoral bruits
    2. Femoral pulses
      1. Delayed or absent in Aortic Coarctation
    3. Symmetrical pulses
    4. Lower extremity shin Hair Loss
  10. Exam: Neurologic
    1. Peripheral Neuropathy
  11. Exam: Skin
    1. Stigmata of Cirrhosis
    2. Neurofibromata
    3. Chloasma
    4. Signs of Cushing's Disease
      1. Striae
      2. Acne Vulgaris
      3. Hirsutism

Hypertensive disease (C0020538)

Definition (NCI) A disorder characterized by a pathological increase in blood pressure; a repeatedly elevation in the blood pressure exceeding 140 over 90 mm Hg.
Definition (MEDLINEPLUS)

Blood pressure is the force of your blood pushing against the walls of your arteries. Each time your heart beats, it pumps out blood into the arteries. Your blood pressure is highest when your heart beats, pumping the blood. This is called systolic pressure. When your heart is at rest, between beats, your blood pressure falls. This is the diastolic pressure.

Your blood pressure reading uses these two numbers, the systolic and diastolic pressures. Usually they are written one above or before the other. A reading of

  • 120/80 or lower is normal blood pressure
  • 140/90 or higher is high blood pressure
  • Between 120 and 139 for the top number, or between 80 and 89 for the bottom number is prehypertension

High blood pressure usually has no symptoms, but it can cause serious problems such as stroke, heart failure, heart attack and kidney failure. You can control high blood pressure through healthy lifestyle habits and taking medicines, if needed.

NIH: National Heart, Lung, and Blood Institute

Definition (NCI) A blood pressure of 140/90 or higher. High blood pressure usually has no symptoms. It can harm the arteries and cause an increase in the risk of stroke, heart attack, kidney failure, and blindness.
Definition (CSP) persistantly high arterial blood pressure.
Definition (MSH) Persistently high systemic arterial BLOOD PRESSURE. Based on multiple readings (BLOOD PRESSURE DETERMINATION), hypertension is currently defined as when SYSTOLIC PRESSURE is consistently greater than 140 mm Hg or when DIASTOLIC PRESSURE is consistently 90 mm Hg or more.
Definition (NCI) Pathological increase in blood pressure; a repeatedly elevated blood pressure exceeding 140 over 90 mmHg.
Concepts Disease or Syndrome (T047)
MSH D006973
ICD9 997.91, 401-405.99
ICD10 I10-I15.9, I10, I10-I15
SnomedCT 38341003, 155295004, 194756002, 155302005, 266287006, 195537001, 194794002, 194757006, 194760004
English Hypertension, BLOOD PRESSURE HIGH, HYPERTENSION, HYPERTENSION ARTERIAL, HYPERTENSIVE DISEASES, Hypertension, NOS, Hypertensive disease, NOS, Hypertensive disease NOS, Hypertensive diseases, [X]Hypertensive diseases, hypertension, Hypertension, arterial, Hypertensive cardiovascular disease or syndrome, Systemic hypertension, Hypertensive disorder, systemic arterial, hyperpiesia, hyperpiesis, systemic HTN, systemic hypertension (diagnosis), systemic hypertension, hypertensive disorder, vascular hypertension, 3-02 HYPERTENSIVE DISEASES, hbp, high bp, htn, (Hypertensive disease) or (hypertension) (disorder), Hypertensive disease (disorder), Hypertensive disease NOS (disorder), Hypertension arterial, Blood pressure high, HBP, HT, Hypertension NOS, [X]Hypertensive diseases (disorder), Surg comp - hypertension, HTN, HIGH BLOOD PRESSURE, PRESSURE, HIGH BLOOD, BLOOD PRESSURE, HIGH, High Blood Pressure, INCREASED BLOOD PRESSURE, BLOOD PRESSURE, INCREASED, Hypertension [Disease/Finding], hypertensive vascular disease, arterial hypertension, arterial hypertension systemic, blood high pressure, high blood pressure disorder, systemic arterial hypertension, hypertensive disease, Hypertensive diseases (I10-I15), high blood pressure, High blood pressure, Hyperpiesia, Hyperpiesis, Hypertensive vascular degeneration, Hypertensive vascular disease, BP - High blood pressure, High blood pressure disorder, Systemic arterial hypertension, HBP - High blood pressure, BP+ - Hypertension, HT - Hypertension, Hypertensive disorder, systemic arterial (disorder), Hypertensive disorder, HTN - Hypertension, blood pressure; high, high; arterial tension, high; blood pressure, (Hypertensive disease) or (hypertension), Raised blood pressure (disorder), Blood Pressure, High, Blood Pressures, High, High Blood Pressures, Vascular Hypertensive Disorder, Hypertensive disease, HYPERTENSIVE DISEASE
French HYPERTENSION ARTERIELLE, Pression artérielle élevée, PAH, Hypertension SAI, TH, HYPERTENSION, TENSION ARTERIELLE E, Hypertension chronique, Hypertension permanente, Hypertension artérielle, Hypertension
Portuguese HIPERTENSAO, Hipertensão arterial NE, Hipertensão arterial, Pressão arterial alta, HYPERTENSAO ARTERIAL, PRESSAO SANGUINEA ELEVADA, Pressão Arterial Alta, Pressão Sanguínea Alta, Hipertensão
Spanish HIPERTENSION, PRESION SANGUINEA ALTA, Presión sanguínea alta, HTA, Hipertensión NEOM, Hipertensión arterial, HT, Hypertension, Hypertensive disease, High blood pressure, (Hypertensive disease) or (hypertension), Hypertension NOS, HIPERTENSION ARTERIAL, [X]enfermedades hipertensivas (trastorno), [X]enfermedades hipertensivas, Hypertensive disease NOS, degeneración vascular hipertensiva, enfermedad hipertensiva, SAI (trastorno), enfermedad hipertensiva, SAI, enfermedad hipertensiva, enfermedad vascular hipertensiva, hiperpiesia, hiperpiesis, hipertensión arterial (trastorno), hipertensión arterial, presión arterial alta, tensión arterial alta, tensión arterial elevada, Hipertension, Hipertensión, Presión Sanguínea Alta, Presion Sanguinea Alta
German HYPERTONIE, Hypertonie, arteriell, Blutdruck, hoch, HBP, HT, Hypertonie NNB, BLUTDRUCK HOCH, HYPERTONIE ARTERIELL, Hypertension, Hypertonie
Dutch hypertensie NAO, hoge bloeddruk, arteriële hypertensie, bloeddruk; hoog, hoog; arteriële druk, hoog; bloeddruk, hypertensie, Bloeddruk, hoge, Hypertensie
Italian Ipertensione (HT), Ipertensione NAS, Pressione del sangue elevata, Ipertensione, Pressione sanguigna alta, Ipertensione arteriosa
Japanese 動脈性高血圧, 高血圧NOS, コウケツアツ, コウケツアツNOS, ドウミャクセイコウケツアツ, 高血圧, 高血圧症
Swedish Högt blodtryck
Czech hypertenze, Arteriální hypertenze, Vysoký krevní tlak, Hypertenze NOS, Hypertenze, vysoký krevní tlak
Finnish Kohonnut verenpaine
Russian GIPERTENZIIA, GIPERTONICHESKAIA BOLEZN', KROVIANOE DAVLENIE VYSOKOE, ГИПЕРТЕНЗИЯ, ГИПЕРТОНИЧЕСКАЯ БОЛЕЗНЬ, КРОВЯНОЕ ДАВЛЕНИЕ ВЫСОКОЕ
Croatian HIPERTENZIJA
Polish Nadciśnienie
Hungarian Arteriás hypertonia, Hypertensio, HT, RR magas, Hypertonia k.m.n., Magas vérnyomás
Sources
Derived from the NIH UMLS (Unified Medical Language System)


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