For middle-aged and elderly patients with long history of hypertension, we should try to have "routine + selective" physical examination once or twice a year, especially for patients with more unhealthy lifestyle and poor blood pressure control, we should pay more attention to health examination, and the examination interval can be carried out according to the doctor's advice.
What to notice when having hypertensive physical examination
What are you looking for? Here are some inspection recommendations for reference.
Basic project
Similar to the general physical examination items, it can be used as a routine examination item. It is recommended that every patient with hypertension should be examined.
General information: height, weight, abdominal circumference, lifestyle;
Blood pressure measurement;
heart
Possible complications: ventricular hypertrophy, coronary heart disease, myocardial infarction, chronic heart failure, etc.
Recommended items: 24-hour ambulatory blood pressure monitoring, echocardiography, chest X-ray examination.
brain
Possible complications: cerebral hemorrhage, ischemic stroke, transient ischemic attack, lacunar infarction, cerebral micro aneurysm, etc.
Recommended items: (enhanced) brain CT or brain MRI.
kidney
Possible complications include renal artery embolization, hypertensive nephritic sclerosis, diabetic nephropathy, impaired renal function, or chronic renal failure.
Recommended items: urine protein quantitation (for urine routine examination of protein positive), urine albumin quantification (diabetes must be investigated).
eye
Possible complications: retinal arteriosclerosis, retinal exudation and hemorrhage, optic disc edema, etc.
Recommended examination: fundus examination.
Note: before the physical examination, you can't stop taking the medicine by yourself, even if you need to adjust the medication time, you should also do it under the guidance of the doctor.
Pay attention to abnormal symptoms
At the same time, patients with high blood pressure should also understand that health examination is only a means to preliminarily assess our blood pressure control and physical health in the past period of time. We must not ignore some abnormal "alarms" in our body just because there is no abnormality in one or two examinations, because sometimes the "little monster" has a very cunning fighting strategy.
The common abnormal symptoms of patients with hypertension are as follows:
brain
Dizziness, headache, nausea, vomiting, disturbance of consciousness, sensory or motor disturbance, etc.
heart
Chest pain, palpitation, fatigue, shortness of breath or dyspnea, ankle edema, etc.
kidney
Polyuria, nocturia, hematuria, etc.
Peripheral arterial disease
Fingers, toes cold, long time walking will appear pain, limp situation.
eye
Blurred vision, etc.
Especially when the above symptoms or some other discomfort symptoms appear many times in a short period of time, even if the symptoms are relatively mild, you should not be careless, and go to the hospital in time. It's likely that high blood pressure is already damaging these organs.
Blood biochemistry: blood potassium, fasting blood glucose, blood lipid, uric acid and creatinine;
routine blood test
Urine analysis: urine protein, urine sugar, urine sediment microscopic examination, etc;
electrocardiogram
For different parts, you can choose different items for inspection. We'd better choose the appropriate examination items under the guidance of community doctors or specialists, combined with their own conditions.
Regular follow-up
In addition to physical examination, it is suggested that patients with hypertension should also go to a specialist to "report" on a regular basis to learn about blood pressure control and adjust drugs.
Each patient's condition is not the same, there is no fixed review period, according to the severity of the disease, can be 1 to 3 months for a follow-up visit; If it is just found that patients with hypertension, control level is not up to standard, blood pressure is not stable, it is best to visit again every 2 weeks.
During the follow-up visit, pay attention to the previous case information, medication, and record the blood pressure of one week, so that the doctor can evaluate the condition and adjust the next treatment plan.
