Davies R, Kapila H
Br J Hosp Med. 1983 May;29(5):428, 430-1, 434 passim.
Ferguson (1975) calculated that if 5 per cent of the estimated 20 million patients with hypertension in the USA had a secondary cause, the cost of their investigation would amount to $2 billion at 1975 prices. For the majority of patients a careful clinical appraisal together with simple biochemical screening tests and a baseline ECG and chest film are adequate before embarking on therapy. For those patients in whom there are clinical or other grounds to suspect a treatable secondary cause, a wide range of modern investigative techniques are available. Even if there are no clues to a secondary cause initially, the possibility of such a cause is occasionally suggested by failure of response to triple therapy with, for example, a thiazide, a beta blocker, and a vasodilator. Whether the hypertensives are being treated in general practice or in hospital, a careful initial assessment together with regular supervision is essential to allow the identification of those with potentially curable disease.
弗格森（1975年）计算得出，如果在美国估计的2000万高血压患者中有5%存在继发性病因，按照1975年的价格，对他们进行检查的费用将高达20亿美元。对于大多数患者而言，在开始治疗前，通过仔细的临床评估、简单的生化筛查测试以及基线心电图和胸部X光片就足够了。对于那些有临床或其他理由怀疑存在可治疗的继发性病因的患者，可以采用多种现代检查技术。即使最初没有继发性病因的线索，但例如在使用噻嗪类利尿剂、β受体阻滞剂和血管扩张剂进行三联治疗后无反应，偶尔也会提示存在这种病因的可能性。无论高血压患者是在基层医疗还是在医院接受治疗，进行仔细的初始评估并定期监测对于识别那些患有潜在可治愈疾病的患者至关重要。
