2. In the clinic, it is a good practice to start
examining the patient when he walks into
the room rather than to meet him
undressed on a coach in a cubicle. It is
helpful if the person, who accompanied the
patient, remains by the side of the patient
in the early part of the history taking. He
can provide valuable information about the
complaints or about changes in health or
behaviour of patient in the recent past.
3. Name
Age
Sex
Occupation
Residence
Chief complaint of hypertension
Then ask the following details-
4. Duration and level of elevated BP if known
Symptoms of secondary causes of
hypertension
Symptoms of target organ complications (i.e.
renal failure and heart failure)
Symptoms of cardiovascular disease (e.g.
CHD and cerebrovascular disease)
Symptoms of concomitant disease that will
affect prognosis or treatment (e.g. diabetes
mellitus, heart failure, renal disease and gout)
5. Family history of hypertension, CHD, stroke,
diabetes, renal disease or dyslipidemia
Dietary history including salt, caffeine,
liquorice and alcohol intake.
Drug history of either prescribed or over the
counter medication and traditional or
complementary medicine treatment.
Lifestyle and environmental factors that will
affect treatment and outcome (e.g. smoking
physical activity, work stress)
6. General examination including height, weight
and waist circumference
Two or more BP measurements separated by
1-2 minutes with the patient either supine or
seated , and after standing for at least one
minute
Take standing BP at 2 minutes and again at 5
minutes in the elderly, diabetes and other
conditions where postural hypotension is
frequent or suspected.
Measure BP on both arms
7. Examination for carotid bruit, abdominal
bruit, presence of peripheral pulses and radio
-femoral delay.
Cardiac examination
Abdominal examination for renal masses,
aortic aneurysm and abdominal obesity.
Neurological examination to look for
evidence of stroke
Sign of endocrine disorders (e.g. Cushing
syndrome, acromegaly, and thyroid diseases
