n CME : Your SA Journal of CPD - Hypertension and its management : what a family physician needs to know : main article

Volume 24, Issue 5
  • ISSN : 0256-2170



In a nutshell, the following are the key points in family medicine and primary health care with regard to hypertension: <BR>Blood pressure should be recorded accurately. <BR>Most patients with hypertension have neither signs nor symptoms. <BR>Approximately 20% of patients who by all other criteria have essential hypertension have suppressed plasma renin activity. <BR>Investigations include: urinalysis - protein, glucose and blood, urea and electrolytes, creatinine, random blood glucose, electrocardiogram: there may be changes consistent with left ventricular hypertrophy secondary to hypertension. in the ECG SV&lt;sub&gt;1&lt;/sub&gt; + RV&lt;sub&gt;5&lt;/sub&gt; or RV&lt;sub&gt;6&lt;/sub&gt; (whichever is tallest) > 35 mm (Sokolow Lyon criterion), random total cholesterol level. <BR>There are 3 important antihypertensive agents for the management of persons without compelling indications: diuretics (thiazide-like and thiazide), angiotensin-converting enzyme inhibitors (ACE-I) and calcium-channel blockers (CCBs). <BR>For a full discussion of antihypertensive treatment see the recent South African Hypertension Society Guideline 2006.

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