Caris T N
South Med J. 1978 Apr;71(4):403-7. doi: 10.1097/00007611-197804000-00019.
Traditionally the initial evaluation of a patient with high blood pressure has focused on exluding secondary correctable causes of hypertension. Such all-inclusive evaluations are expensive, time-consuming, and expose the patient to some risk. A complete history, physical examination, and relatively simple laboratory procedures such as CBC, urinalysis, SMA-6 and 12, and ECG yield sufficient information to detect damage to target organs caused by elevated blood pressure and to exclude the presence of secondary causes fairly adequately. In that small number of patients in whom clues for correctable causes of hypertension are uncovered, or if patients fail to respond to appropriate treatment for essential hypertension, a more extensive evaluation can be undertaken.
传统上，对高血压患者的初始评估主要集中在排除继发性可纠正的高血压病因。这种全面的评估成本高昂、耗时，且会让患者面临一定风险。完整的病史、体格检查以及相对简单的实验室检查，如血常规、尿常规、血液生化六项和十二项以及心电图，能够提供足够的信息，以检测高血压对靶器官造成的损害，并相当充分地排除继发性病因的存在。对于少数发现有可纠正高血压病因线索的患者，或者如果患者对原发性高血压的适当治疗没有反应，可以进行更广泛的评估。
