When diagnosing arterial hypertension, a number of mandatory medical and laboratory measures are carried out. These include ultrasound, ECG, fluoroscopy, analysis of the patient's fundus. If it is impossible to make an accurate diagnosis, or if additional diseases are associated with hypertension, additional, in-depth studies are prescribed.
Diagnosis of symptomatic arterial hypertension
On this page you will learn about the methods of examination of arterial hypertension, laboratory tests and special studies that are conducted to diagnose the disease. Also below are the indicators of various studies in the norm and pathology.
The main laboratory tests for hypertension are:
- determination of blood protein and glucose in the urine;
- definition of the hematocrit number;
- determination of the content of potassium ions in blood serum;
- determination of serum creatinine and / or urea nitrogen levels in the blood.
In addition, for advanced diagnosis of hypertension in cases of suspected symptomatic hypertension, the following are also used:
- , vasorenal hypertension: digital angiography;
- pheochromocytoma: determination in the daily urine levels of creatinine, metanephrine and catecholamine levels or catecholamine levels in blood plasma.
There are also research methods that are used comparatively less frequently due to some special moments:
- microscopic analysis of urine;
- determination of the leukocyte blood count;
- determination of glucose, cholesterol and triglycerides in blood plasma;
- determination of calcium, phosphate and uric acid in serum.
The most widely applicable instrumental studies include the following:
- chest X-ray;
- examination of the fundus.
During the examination for suspected hypertension, it is necessary, first of all, to focus on the functional state of the kidneys( using clinical, biochemical, radiological, radioisotope and ultrasound methods), the adrenal glands, the pituitary gland and other organs and systems in which the symptom of high blood pressure develops.
Modern chart of examination of patients with arterial hypertension
Modern scheme of examination of patients with arterial hypertension, recommended by WHO experts:
- mandatory research : general urine analysis;in blood plasma - the level of creatinine and potassium;
- ECG ;
- additional studies of : high glucose, cholesterol, triglyceride and lipoprotein content, uric acid, sodium in the blood serum;hemoglobin and hematocrit;sowing urine for pathogens;Chest X-ray;echocardiography;
- in-depth examination of hypertension: examination of cerebral, cardiac and renal function;in the blood and urine - the level of renin, angiotensin, aldosterone, corticosteroids, catecholamines.
The most clinically informative laboratory indicators for various diseases of the cardiovascular system:
- Primary hypertension i - urea, potassium, creatinine, lipid metabolism, renin, aldosterone.
- In diseases of the kidneys - urea, creatinine, cortisol, aldosterone, renin, adrenaline, noradrenaline and vanillylmandelic acid in the urine.
Diagnosis of symptomatic arterial hypertension in endocrine diseases:
- with pheochromocytoma - epinephrine and norepinephrine in urine, glucose in blood and urine, renin, non-esterified fatty acids;
- with primary aldosteronism ( Conn's syndrome) - potassium, sodium, aldosterone, renin, 17-ACS;
- with hypercorticism ( Isenko-Cushing syndrome) - ACTH, 17-ACS, 17-CS, renin, glucose, glycemic curve.
Diagnosed arterial hypotension - hydrocortisone, in urine - 17-OX, sodium, potassium.
Atherosclerosis - high and low density lipoproteins, cholesterol, phospholipids, triglycerides.