Further investigations, what for?
Generally speaking, hypertension requires few further investigations.
However they can:
- Look for a cause for your hypertension
- Assess whether your hypertension has already had any effects on your heart
- Look for other risk factors
- Monitor your treatment
- Check the functioning of your kidneys
Do not necessarily expect your doctor to prescribe numerous investigations
Looking for a cause for hypertension
Examinations are conducted to look for a disease that might explain your hypertension,
which is rare. Measuring the sugar and creatinine levels from a blood sample
and
performing a urine analysis are usually enough.
Heart examinations
These are used only to assess the effect of the hypertension on the heart.
 They are examinations for coronary disease and heart failure:
- chest X-ray
- electrocardiogram (ECG)
- echocardiography
Looking for other risk factors
The examinations to monitor treatment.
Some drugs, like diuretics, ARBs, and ACE inhibitors, can modify the concentration
of potassium in the blood (kaliemia) and the functioning of the kidneys. This
warrants a blood test to measure the level of minerals in the blood (blood electrolytes)
and, in certain conditions, measure the creatinine levels.
Investigation of the kidneys and their function
These investigations can have two objectives: looking for kidney disease, which might be causing the hypertension, and assessing the effect of the hypertension on the kidneys.
- The level of creatinine in the blood: it rises if the purification function
of the kidneys is affected. It replaces the measurement of the urea level.
-
Looking for blood in the urine is carried out with a dipstick. If the dipstick is positive, the result is confirmed by a microscope examination
of the urine.
- Looking for albumin in the urine (proteinuria or albuminuria) is also carried out with a dipstick. If it is positive, it may be necessary to
measure the level in the urine over 24 hours.
- Renal ultrasound exam (renal echocardiography)
is totally painless. For the results of the examination to be as accurate as
possible,
avoid
eating dried or fresh fruits and vegetables and cooked fats (fried foods) for
the 4 days before the examination. Do not have any fizzy drinks on the day
before the examination and fast the night before the exam.
- Doppler ultrasonography of the renal arteries:
also painless, but sometimes difficult if the patient is very overweight; in
some cases, it can reveal a constriction of the renal arteries causing so-called
high "renovascular" blood pressure.
- Angiography of the renal arteries,
an examination of the arteries supplying the kidneysusing a product opaque to X rays. It shows the renal arteries (if there is an anomaly this can cause hypertension) and if carried out after the preceding examination, it enables dilatation of the constricted renal artery using a probe with a bladder on the end.
Angiography is painless and causes above all a "hot flush" for a few
seconds at the moment of injection. Before these examinations, take the same precautions as before ultrasound.
|
Dr Elkik |