Objectives:

1. Define appropriate Historical and physical Examination features that indicate secondary causes of Hypertension 2. Describe an approach to initial diagnostic tests appropriate for patients with a new diagnosis of hypertension 3. Assess and interpret key laboratory tests in patients newly diagnosed with hypertension

Evaluation of Blood Pressure:

Select an appropriately sized cuff: The bladder inside the cuff should encircle: 80% of the arm in adults 100% of the arm in children < 13 years.

Inappropriately sized cuffs can falsely elevate the BP. Smaller cuffs are more likely to do so. If in doubt, use a larger cuff. If the available cuff is too small, this should be noted. Image taken from: Rational Clinical Exam, 2008.

Guidelines for Diagnosing Hypertension:

BP is averaged over 2-3 readings on separate visits before making a diagnosis of hypertension in order to avoid over diagnosis.2

Etiology of Hypertension:

References:
1. Diagnostic Approach to Hypertension - Independent Learning Module. Schulich School of Medicine & Dentistry. Feb. 13, 2012. 2. Rational Clinical Exam, 2008. Chapter 23: Does This Patient have Hypertension?