Chronic hypertension physical examination
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Hypertension Main page |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Assistant Editor-In-Chief: Taylor Palmieri
Overview
Physical examination of a patient with isolated hypertension in the absence of target organ damage is usually unimpressive with the exception of high blood pressure. Healthcare providers must nonetheless search thoroughly for findings on physical examination that might suggest target organ damage and associated clinical conditions
Physical Examination
The physical examination should look for end organ disease and underlying causes of hypertension.
Appearance
- Obesity may be present which is a risk factor for hypertension. Measurement of height, weight, waist and abdominal circumferences. Calculation of BMI is required.
Skin
- Diaphoresis would suggest a pheochromocytoma
Head
- Moon facies and Hirsutism would suggest Cushing's syndrome
Eyes
- Examination of the optic fundi is required
- Retinal hemorrhage may be seen in malignant hypertension
- Retinalvenous crossing changes
Neck
- Thyromegaly may be present in the setting of hyperthyroidism
Heart
- S3 and S4 would suggest heart failure
Lung
- Rales would suggest heart failure
Abdomen
- A renal bruit suggests the presence of renovascular hypertension
Arteries
- A carotid, abdominal or femoral bruit might be present
Lower Extremities
- Lower leg edema suggests cardiac or renal causes of hypertension