Doctor, last week 1 just had a check up in our factory and they told me that my Blood pressure is high, What should I take?
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 Hypertension In India it does appear early in forties.
Perform a routine general examination. Check the present Blood pressure, Record the weight. Note if he is obese.
Auscultate the heart, especially aortic area for loud A2, Murmur. Look for evidence of Left ventricular hypertrophy.
Palpate for Renal lump. (Polycystic Kidneys)
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.
Keep the hands gently, over the medial aspect of scapulae, for thrill of intercostals arteries in coarctation.
In every Hypertensive patient, check the blood sugar (Diabetes) and lipid profile (Hyperlipidemias).
Key points for hypertension: LVH, Murmur, Polycystic kidneys, Coarctation of aorta.Action: Restrict salt, oil & ghee. Reduce weight, Regular walking exercise. Anti-hypertensive, and if necessary Tranquillizer & diuretic.
