Harvey J M, Beevers D G
University Department of Medicine, Dudley Road Hospital, Birmingham, UK.
Ann Clin Biochem. 1990 Jul;27 ( Pt 4):287-96. doi: 10.1177/000456329002700403.
Underlying causes of hypertension are found in less than 5% of cases but they are frequently surgically remediable. Elementary biochemical tests are usually sufficient to exclude most renal and endocrine causes of hypertension. However, young patients with very high blood pressures merit more detailed investigation in specialized centres. As coexistent hyperlipidaemia or glucose intolerance substantially worsen the prognosis for a given level of blood pressure, these two risk factors are worth assessing in all hypertensive patients. Their presence may also alter the choice of antihypertensive drug therapy. About 25% of the population have raised blood pressure at first screening and about 10% are in need of drug therapy, so this represents an appreciable load on biochemical laboratories. Most patients, however, need only a single biochemical profile on one occasion, and should be exclusively managed in general practice.
不到5%的高血压病例能找到潜在病因，但这些病因通常可通过手术治疗。基本的生化检查通常足以排除大多数导致高血压的肾脏和内分泌病因。然而，血压极高的年轻患者值得在专科中心进行更详细的检查。由于并存的高脂血症或糖耐量异常会显著恶化特定血压水平下的预后，这两个危险因素值得在所有高血压患者中进行评估。它们的存在也可能改变降压药物治疗的选择。约25%的人群在初次筛查时血压升高，约10%需要药物治疗，因此这给生化实验室带来了相当大的负担。然而，大多数患者只需一次单一的生化检查，应完全在全科医疗中进行管理。
