oa SA Pharmaceutical Journal - Hypertension and its management : clinical
In a nutshell, the following are the key points in family medicine and primary health care with regard to hypertension:
Blood pressure should be recorded accurately.
Most patients with hypertension have neither signs nor symptoms.
Approximately 20% of patients who by all other criteria have essential hypertension have suppressed plasma rennin activity.
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 SV1 + RV5 or RV6 (whichever is tallest) > 35 mm (sokolow lyon criterion), random total cholesterol level.
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). For a full discussion of antihypertensive treatment see the recent South African Hypertension Society Guideline 2006.
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