Hypertension History

• General questions:
  • When was the pt diagnosed?
  • Last known BP
  • Course? regularly monitoring?
  • On treatment? Name? Route? Dose? S\E?
  • Other medications: estrogen (OCP\HRT), steroids, NSAIDs, anticoagulants, anti-platelet
  • Other ds: dyslipidemia, DM, previous stroke

• 2ndry causes:
  • Polycystic: flank pain
  • Adrenal: muscle weakness, cramps
  • Pheochromocytoma: attacks of HTN, tremor, sweating, headache, palpitation
  • Cushing’s: thinning of the skin, easy bruising, fractured bone, swelling, abdominal
  • OSA: sleep disturbances, daytime sleepiness

• Target organ damage:
  • CNS: Headache, loss of consciousness
  • Eyes: Blurred vision, loss of acuity, blindness
  • Heart: Chest pain, SOB
  • PVD: Claudication
  • Kidney: Frothy urine, hematuria

• FMHx:
  • HTN
  • Premature CVD\death
  • Familial ds: DM, renal ds, gout

• Other risk factors:
  • Smoking, alcohol, illicit drugs (especially amphetamine and cocaine)
  • Diet (sodium, high fat)
  • Physical activity
  • Social: family, work, psych (stress)

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