What Tests Should Be Done for High Blood Pressure in Young People?

High blood pressure in young people is mainly related to poor dietary habits and lifestyle habits. Once hypertension occurs, it is necessary to promptly go to the hospital for examination, usually including physical examination and laboratory tests.

(1) Correct measurement of blood pressure. Since blood pressure has fluctuations, and emotional excitement and physical activities can cause temporary increases in blood pressure, hypertension should be diagnosed only when blood pressure rises are measured at least twice in a non-consecutive day under resting conditions, and the blood pressure value should be calculated as the average of three consecutive measurements. Careful physical examination helps to discover clues of secondary hypertension and target organ damage.

(2) Measurement of body mass index (BMI), waist circumference, and hip circumference.

(3) Examination of arterial pulsation and neurological signs in the limbs, auscultation for murmurs in the carotid, thoracic aorta, abdominal artery, and femoral artery.

(4) Observation for signs of Cushing's syndrome, neurofibromatous skin lesions, thyrotoxic ophthalmopathy, or lower extremity edema.

(5) Comprehensive cardiopulmonary examination.

(6) Detailed understanding of the patient's medical history.

Laboratory tests can help determine the cause of hypertension and the functional status of target organs. Routine test items include blood routine, urine routine (including protein, sugar, and urine sediment microscopy), renal function, blood sugar, blood lipids, blood potassium, echocardiography, electrocardiogram, chest X-ray, fundus examination, ambulatory blood pressure monitoring, etc. Further fundus examination and carotid ultrasound can be performed according to needs and conditions.

24-hour ambulatory blood pressure monitoring helps to assess the severity of hypertension, understand circadian blood pressure rhythm, monitor morning blood pressure, guide antihypertensive treatment, and evaluate the effectiveness of antihypertensive drugs.

Based on the patient's medical history, physical examination, and laboratory test results, hypertension can be diagnosed. The diagnosis should include: determining the blood pressure level and hypertension grade; assessing the presence of other cardiovascular disease risk factors; determining the cause of hypertension and identifying the presence of secondary hypertension; evaluating the condition of target organs such as the heart, brain, and kidneys; and assessing the patient's risk of cardiovascular events.