Kteich Katia, Karam Maria R, Zoghbi Marouan, Aoun Mabel
Faculty of Medicine, Saint-Joseph University of Beirut, Beirut, Lebanon.
Fondation AUB Santé, Lorient, France.
PLoS One. 2025 May 29;20(5):e0324743. doi: 10.1371/journal.pone.0324743. eCollection 2025.
Hypertension is a key contributor to the global cardiovascular disease burden. In 2021, the World Health Organization (WHO) hypertension management guideline suggested baseline laboratory tests for patients with newly diagnosed hypertension but noted limited evidence in primary care contexts. This study evaluates the impact of baseline laboratory assessments on blood pressure control and comorbidities in newly diagnosed hypertensive patients.
This is a multicenter retrospective study that included all patients with new-onset hypertension between January 2015 and January 2020, followed in three primary health care centers until 2022. Data collection included 8 items of paraclinical tests performed at the diagnosis of hypertension: serum sodium, potassium and creatinine, lipid panel, electrocardiogram, glucose, HbA1c and urine dipstick. Complete workup was defined as having the 8 items checked and partial workup included 1-7 items. Blood pressure was assessed at one year and the final visit, which was beyond one year, in the two workup groups.
Of 621 hypertensive patients, 107 with incident hypertension were analyzed (mean age: 54.8 ± 12.7 years; 58.9% women). A complete workup was done for 48 patients, partial for 52 and none for 7. Abnormalities detected included: 8.4% of patients with fasting blood glucose > 125 mg/dL, 7.5% with HbA1c > 6.5%, 1.9% with serum potassium < 3.5 mmoL/L, 54.2% with LDL Cholesterol > 100 mg/dL, 35.5% with serum creatinine > 0.8 mg/dL, and 7.5% with an estimated GFR < 60 mL/min/1.73 m2. Significant systolic blood pressure improvement was seen at 12 months in the complete workup group (129.9 ± 13.6 mmHg) vs. partial workup group (142.8 ± 18.9 mm Hg) (P = 0.003). Men and smokers were tested more often than women and non-smokers.
Baseline laboratory tests in patients with newly diagnosed hypertension help unmask comorbidities such as chronic kidney disease, diabetes, and dyslipidemia. Our findings support the use of baseline laboratory testing in order to optimize blood pressure control and individual patient management.
高血压是全球心血管疾病负担的关键因素。2021年，世界卫生组织（WHO）高血压管理指南建议对新诊断的高血压患者进行基线实验室检查，但指出在初级保健环境中的证据有限。本研究评估基线实验室评估对新诊断高血压患者血压控制和合并症的影响。
这是一项多中心回顾性研究，纳入了2015年1月至2020年1月期间所有新发高血压患者，并在三个初级卫生保健中心随访至2022年。数据收集包括高血压诊断时进行的8项辅助检查项目：血清钠、钾和肌酐、血脂谱、心电图、血糖、糖化血红蛋白和尿试纸条检查。完整检查定义为检查了8项，部分检查包括1 - 7项。在两个检查组中，分别在1年时和最后一次随访（超过1年）时评估血压。
在621例高血压患者中，分析了107例初发高血压患者（平均年龄：54.8±12.7岁；58.9%为女性）。48例患者进行了完整检查，52例进行了部分检查，7例未进行检查。检测到的异常情况包括：8.4%的患者空腹血糖>125mg/dL，7.5%的患者糖化血红蛋白>6.5%，1.9%的患者血清钾<3.5mmol/L，54.2%的患者低密度脂蛋白胆固醇>100mg/dL，35.5%的患者血清肌酐>0.8mg/dL，7.5%的患者估算肾小球滤过率<60mL/min/1.73m²。完整检查组在12个月时收缩压有显著改善（129.9±13.6mmHg），而部分检查组为（142.8±18.9mmHg）（P = 0.003）。男性和吸烟者比女性和非吸烟者接受检查的频率更高。
新诊断高血压患者的基线实验室检查有助于发现慢性肾病、糖尿病和血脂异常等合并症。我们的研究结果支持使用基线实验室检查以优化血压控制和个体患者管理。
