Stop salt intake completely even the salt in cooking.
Bed rest if necessary, hospitalize.
Refer to aphysician for advise and investigations if above measures fail to control the B.P.
Check the following regularly
B.P every month. (more frequently if fluctuating)
S. Cholestrol and Blood sugar – every year.
X-ray chest and ECG – for baseline readings.
If severe, uncontrolled Hypertension is seen in younger patients (below 30 years). Refer the patient to a physicion or nephrologists to investigate for Renal hypertension.
It is the general practioner’s duty to see that the patient takes th drugs regularly and keep B.P under control. Many patients believe that if they have no headache, then BP is under control, and take tablets only when symptomatic! Urge to take tablets regularly.
If the patient is asthamatic, do not give Beta-blockers. And if a patient on anti-hypertensives, complains of chronic mild cough, check whether he is receiving Beta-blocker.
Keep sublingual NifeDEPIN at hand for Hypertensive emergencies.
Doctor, last week 1 just had a check up in our factory and they told me that my Blood pressuse is high, What should I take?
1. Do you get headache, giddiness, breathlessness? No.
Do you have diabetes? No.
Do you feel weak or pass urine more frequently? No.
(Well there are no symptoms of Diabetes.)
Has anybody in your family high blood pressure? Father, mother, uncles, or brother? Yes. My father has high blood pressure. (Then this may be Essential Hyertension In India it does appear early in forties.
1. Perform a routine general examination. Check the present Blood pressure, Record the weight. Note if he is obese.
1. Ausculate the heart, especially aortic area for loud A2, Murmur. Look for evidence of Left ventricular hypertrophy.
1. Palpate for Renal lump. (Polycystic Kidneys)
1. Palpate the Radial pulse. Then palpate the femoral pulse simultaneously. If there is a Radio-femoral delay, it is Co-arctation of Aorta? Check the B.P. in lower limb also, If the difference is more than 20mm, it is coarctation.
1. Keep the hands gently, over the medial aspect of scalpulae, for thrill of intercostals aereries in coarctation.
1. In every Hypertensive patient, check the blood sugar (Diabetes) and lipid profile (Hpyperlipidemias).
