This site is intended for healthcare professionals

CPD
CPD
Pro
Pro
account_circleSign in
Go to /sign-in page

You can view 5 more pages before signing in

Go to /pro/cpd-dashboard page

This page is worth 0.05 CPD credits. CPD dashboard

Go to /account/subscription-details page

This page is worth 0.05 CPD credits. Upgrade to Pro

Investigations

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

Authoring team

The search for a cause of hypertension should be more thorough in the young, severe hypertensive, and more restrained in older patients.

NICE recommends that in all people with hypertension, offer to:

  • test urine
    • test for the presence of protein in the urine by sending a urine sample for estimation of the albumin:creatinine ratio and test for haematuria using a reagent strip
  • measure plasma glucose, electrolytes, creatinine, estimated glomerular filtration rate, serum total cholesterol and HDL cholesterol
  • examine the fundi
    • for the presence of hypertensive retinopathy
  • arrange for a 12-lead electrocardiograph should be undertaken (1)

Use of fasting blood samples will allow assessment of fasting glucose and assessment of triglyceride levels (1)

Further investigations should be guided by clinical suspicion of other factors such as heart failure or secondary causes of hypertension.

The American college of cardiology recommends the following basic and optional laboratory tests for primary hypertension:

  • basic
    • fasting blood glucose (may include a comprehensive metabolic panel)
    • complete blood count
    • lipid profile
    • serum creatinine with estimated glomerular filtration rate
    • serum sodium, potassium, calcium
    • thyroid-stimulating hormone
    • urinalysis
    • electrocardiogram
  • optional
    • echocardiogram
    • uric acid
    • urinary albumin to creatinine ratio (2)

NICE suggest that:

  • if hypertension is not diagnosed but there is evidence of target organ damage such as left ventricular hypertrophy, albuminuria or proteinuria, consider carrying out investigations for alternative causes of the target organ damage (1)

Reference:

Related pages

Create an account to add page annotations

Create a free account

Annotations allow you to add information to this page that would be handy to have on hand during a consultation. E.g. a website or number. This information will always show when you visit this page.