Hypertension

Hypertension: 140/90 on 2 consecutive visits 2 weeks apart.
I. Primary (essential)
II. Secondary (exogenous substances, renal failure, sleep apnea, renovascular disease, primary aldosteronism, pheochromocytoma, Cushing syndrome)

History suggesting Secondary causes:

Onset of HTN befor 20 y.o. or after 50 y.o.
hx of tachycardia, sweating, headache
personal or family hx of renal disease
HTN that is resistant (in a compliant patient)
symptoms indicating sleep apnea
drug use: amphetamine, cocaine, alcohol abuse
medication use: oral contraceptives, estrogens, corticosteroids, NSAIDs
hx of hirsutism or easy bruising

Physical examination:

-elvated BP (2 consecutive visits 2 weeks apart);

exceptions:

-if SBP is 210 or more or

-a DBP 120 or more or

-end-organ damage.

Diagnostic evaluation:

CBC, fasting serum glucose, K+, serum creatinine, UA, lipid profile, Calcium (with albumin), uric acid. ECG, chest xray, ambulatory BP (for patient with white-coat HTN), serum TSH.