Assessment for Identifiable Ideologies of Hypertension

There are also many medications, supplements, and physiological conditions that play a role in hypertension. The medical history should include questions on:

  • NSAIDS
  • Decongestants
  • Amphetamines
  • Antidepressants
  • Atypical antipsychotics
  • Angiogenesis inhibitor
  • Systemic corticosteroids
  • Oral contraceptives
  • Caffeine (intake > 300 mg/d)
  • Alcohol
  • Herbal supplements e.g., ginkgo, ginseng, licorice, and St. John’s wort
  • Recreational drugs

Common Physiological Causes

  • Diabetes mellitus
  • Dyslipidemia/Hypercholesterolemia (high lipid/high cholesterol readings)
  • Renal parenchymal diseases
  • Renovascular diseases
  • Primary aldosteronism
  • Drug or alcohol-induced
  • Obstructive sleep apnea

Uncommon Physiological Causes

  • Pheochromocytoma/paraganglioma
  • Cushing’s syndrome
  • Hypothyroidism
  • Hyperthyroidism
  • Primary hyperparathyroidism
  • Congenital adrenal hyperplasia
  • Undiagnosed or repaired aortic coarctation
  • Mineralocorticoid excess syndromes (other than primary aldosteronism)
  • Acromegaly

With the new AHA guidelines, medical providers are encouraged to utilize the atherosclerotic cardiovascular disease risk calculator (ASCVD) to assess the patient’s risk of developing heart disease or stroke within 10 years. The calculator is a standardized guideline to predict risk and recommend management strategies for those at risk of ASCVD. It includes a history questionnaire of ASCVD e.g., acute coronary syndrome, myocardial infarction, stable angina, coronary/or other arterial revascularization, stroke, transient ischemic attack, or peripheral artery disease.