Hypertension

CLINICAL DIAGNOSTIC MANUAL

Hypertension (HTN) is a chronic condition characterised by a persistent elevation of blood pressure in the systemic arteries. This condition is a significant risk factor for cardiovascular, renal, and cerebrovascular diseases.

Hypertension can be primary (essential), where no specific cause is identified, or secondary, where it results from another medical condition. Proper diagnosis and treatment are crucial to prevent long-term complications.

Pathology	Suspected Diagnosis	Confirmatory Diagnosis
Transient hypertension	Temporary elevation of blood pressure, often associated with stress or anxiety.	Repeated blood pressure measurements at rest.
Essential hypertension	Persistent elevation of blood pressure with no identifiable cause, family history.	Diagnosis of exclusion, clinical history, physical examination.
Pregnancy-induced hypertension	Elevated blood pressure during pregnancy, especially in the third trimester.	Blood pressure measurement, urine analysis for proteinuria.
Obstructive sleep apnoea	Treatment-resistant hypertension, daytime sleepiness, nocturnal snoring.	Polysomnography, sleep study.
Renal hypertension	Severe or resistant hypertension, impaired renal function, history of kidney disease.	Renal ultrasound, renal function tests, renal angiography.
Endocrine-related hypertension	Hypertension associated with endocrine symptoms, such as hyperaldosteronism, pheochromocytoma, hyperthyroidism.	Specific hormonal tests, imaging studies (CT, MRI).
Vascular hypertension	Hypertension secondary to arterial stenosis, claudication, abdominal bruit.	Angiography, Doppler ultrasound of renal arteries.
Medication-induced hypertension	Blood pressure elevation temporally associated with the use of certain drugs (steroids, NSAIDs, oral contraceptives).	Clinical history, medication review.