Clinical features

Complaints: pain at the heart, palpitation, headache, dizziness, disorder of vision. At the expressed left ventricular failure - attacks of dyspnea.

Objective examination. General patient condition is usually satisfactory. On progression of disease and appearance of complication general patient's condition may be from middle grave to grave (hypertension crisis, acute and chronic heart failure and cerebral attacks).

The color of the skin may be hyperemic. As usually the patients are overweight. At development of heart failure acrocyanosis and peripheral edema are observed.

Objective examination of the cardiovascular system. Apex beat is displaced to the left and downwards, diffuse, high. Displacement of the left border of the relative cardiac dullness to the left is observed. Increased loudness of the first heart sound at the heart apex and accentuated second heart sound over aorta are heard. At the presence of heart failure the gallop rhythm is heard. Blood pressure > 140/90 mm Hg. Pulse is firm tension (p. durus).

Protocol of diagnostic procedures for patients with hypertension I-II stages

Obligatory examination:

- inquiry;

• physical examination: measurement of blood pressure on both hands, measurement of blood pressure on lower extremities at persons younger 45 years; measurement of body weight of and waist circumference;

• laboratory routine examination hemoglobin and hematocrit, clinical urine analysis, Nechiporenko's test, Zemnicky's test, biochemical blood analysis: serum creatinine, serum potassium, serum total cholesterol, serum low density lipoprotein (LDL) cholesterol, serum high density lipoprotein (HDL) cholesterol, fasting serum triglycerides;

• ECG in 12 standard leads;

• echocardiography;

• fundoscopic examination.

Special examination:

• determination of microalbuminuria;

• daily proteinuria;

• ambulatory blood pressure measurement using monitor;

• ultrasound examination of kidneys.

Protocol of diagnostic procedures for patients with hypertension III stages

Obligatory examination:

• inquiry;

• physical examination: - measurement of blood pressure on both hands, measurement of blood pressure on lower extremities at persons younger 40 years;

• measurement of body weight and waist circumference;

• laboratory routine examination hemoglobin and hematocrit, clinical urine analysis, Nechiporenko's test, Zemnicky's test, biochemical blood analysis: serum creatinine, serum potassium, serum total cholesterol, serum low density lipoprotein (LDL) cholesterol, serum high density lipoprotein (HDL) cholesterol, fasting serum triglycerides;

• ECG in 12 standard leads;

• echocardiography;

• examination of the eyes;

• X-ray examination of the chest;

• ultrasound examination of kidneys.

Special examination:

• ambulatory blood pressure measurement using monitor;

• doppler-ultrasound scanner of extracranial vessels;

• computer tomography and magnitoresonance tomography of head;

• in case of coronary heart diseases - cardioventnculography.