Hypertension

1. Diagnostic Tests & Labs

1.1. Electrocardiogram (ECG)

1.2. Lipid profile (LDL, HDL, cholesterol, triglycerides) (Whelton et al., 2018).

1.3. Urinalysis

1.4. Echocardiogram

1.5. Renal function testing (sodium, potassium, chloride, BUN, creatinine, eGFR) (Whelton et al., 2018).

1.6. Blood pressure management/monitoring

2. Treatment & Medications

2.1. Clonidine (rescue)

2.2. Hydralazine (IV/Oral) (Messerli et al., 2018).

2.3. Nifedipine (CCB)

2.4. Olmesartan (ARB) (Messerli et al., 2018).

2.5. Valsartan (ARB)

3. Possible Referrals

3.1. Endocrinologist (if secondary HTN)

3.2. Cardiologist

3.3. Nutritionist/Dietitian

3.4. Ophthalmologist

3.5. Nephrologist

4. Signs & Symptoms

4.1. Impaired or blurred vision (Williams et al., 2018).

4.2. Dizziness

4.3. Aneurysm (Whelton et al., 2018).

4.4. Fatigue

4.5. Headache

4.6. Palpitations (Williams et al., 2018).

5. Pathophysiology & Etiology

5.1. Elevated vascular resistance

5.2. Endothelial impairment

5.3. Overactivation of the Renin-Angiotensin-Aldosterone System (Ungar et al., 2020).

5.4. Hyperactivity of the sympathetic nervous system

6. Risk Factors

6.1. Obesity

6.2. Smoking (Zhou et al., 2021).

6.3. Excessive alcohol intake

6.4. High sodium diet (Zhou et al., 2021).

6.5. Sedentary lifestyle (Zhou et al., 2021).

6.6. Genetic susceptibility

7. Complications & Systemic Impact

7.1. Peripheral arterial disease

7.2. Chronic kidney disease (Whelton et al., 2018).

7.3. Heart failure

7.4. Retinopathy (Whelton et al., 2018).

7.5. Aneurysm

7.6. Stroke

8. References

8.1. Williams, B., Mancia, G., Spiering, W., Rosei, E. A., Azizi, M., Burnier, M., ... & Tsioufis, C. (2018). 2018 ESC/ESH Guidelines for the management of arterial hypertension. European Heart Journal, 39(33), 3021-3104. https://doi.org/10.1093/eurheartj/ehy339

8.2. Ungar, A., Rivasi, G., Rafanelli, M., & Mossello, E. (2020). Pathophysiology of hypertension in the elderly as a basis for drug treatment. Current Hypertension Reports, 22(3), 1-10. https://doi.org/10.1007/s11906-020-1034-5

8.3. Whelton, P. K., Carey, R. M., Aronow, W. S., Casey, D. E., Collins, K. J., Dennison Himmelfarb, C., ... & Wright, J. T. (2018). 2017 ACC/AHA guideline for the prevention, detection, evaluation, and management of high blood pressure in adults. Journal of the American College of Cardiology, 71(19), e127-e248. https://doi.org/10.1016/j.jacc.2017.11.006

8.4. Messerli, F. H., Bangalore, S., & Bavishi, C. (2018). Angiotensin-converting enzyme inhibitors in hypertension: To use or not to use? Journal of the American College of Cardiology, 71(13), 1474-1482. https://doi.org/10.1016/j.jacc.2017.12.059

8.5. Zhou, B., Perel, P., Mensah, G. A., & Ezzati, M. (2021). Global epidemiology, health burden, and effective interventions for elevated blood pressure and hypertension. Nature Reviews Cardiology, 18(11), 785-802. https://doi.org/10.1038/s41569-021-00559-8