After taking a medical history and doing a physical examination, certain tests may be necessary. This will depend on the severity of the hypertension and presence of risk factors and organ damage.

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Some of the routine investigations may be: 

• a urine trip test to test for blood, protein and glucose. This gives a rough indication of kidney function and possible diabetes.
• The possibility of pregnancy can easily be overlooked. Inform you doctor if you have any suggestive symptoms or signs. A quick urine test can confirm pregnancy.
• Fasting blood tests can help confirm or rule out diabetes, and determine your cholesterol status. 
• The total cholesterol, LDL- & HDL- cholesterol and triglyceride levels can be tested. 
• If indicated, a full blood count and blood chemistry will be done.
• If chest X-rays have not been done in the previous year or two, it may be ordered to evaluate the lungs and heart size. It will depend on the patient’s smoking habits and other risk factors. 
• A heart test, called an electrocardiogram (ECG), that is based on the electrical activity of the heart, is usually done. A resting ECG is recommended to evaluate the heart. 
• Patients who have symptoms suggestive of heart disease might need a stress-ECG. The test is done during exercise. Men older than 45 years and post-menopausal women are often given a stress-ECG to help detect coronary problems. The coronary arteries supply the heart muscle with oxygen and nutrients.

Dr Kathleen Coetzee, MBChB

Read more:
Hypertension in the elderly
Hypertension – a real life story

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