Diagnostic tests for hypertension

Pro Research Analysisby

Searched over 200M research papers

Analyzed relevant papers

Blood Pressure Measurement Methods for Hypertension Diagnosis

The primary diagnostic test for hypertension is blood pressure (BP) measurement. Clinic BP readings remain the initial step, but out-of-office measurements are strongly recommended to confirm the diagnosis and avoid misclassification due to white-coat hypertension. The gold standard is 24-hour ambulatory blood pressure monitoring (ABPM), which provides a comprehensive profile of BP throughout the day and night. Home blood pressure monitoring (HBPM) is an acceptable alternative, where patients record BP readings twice daily for several days. Kiosk-based BP measurements are also being evaluated for their comparability and acceptability. The diagnostic threshold for hypertension is 140/90 mmHg in the clinic, and 135/85 mmHg for ABPM or HBPM. If the mean BP is close to the threshold, ABPM may be needed to confirm the diagnosis, especially in younger adults. Standing BP measurements are recommended for certain populations, such as those with diabetes or symptoms of postural hypotension 4810.

Laboratory and Biochemical Tests in Hypertension Diagnosis

Laboratory medicine plays a key role in the initial evaluation and ongoing management of hypertension. Routine blood and urine tests help assess for secondary causes, monitor organ damage, and evaluate cardiovascular risk factors. Important tests include kidney function tests, electrolyte panels, lipid profiles, and glucose measurements. These tests help identify comorbidities like chronic kidney disease, diabetes, and dyslipidemia, and can detect hypertension-mediated organ damage. Biochemical testing is also essential for screening for secondary hypertension, such as primary aldosteronism, where the aldosterone-to-renin ratio is a critical marker. The results of these tests guide risk stratification and management decisions 59.

Diagnostic Testing in Special Populations: Pediatric Hypertension

In children and adolescents, diagnostic testing aims to distinguish between primary and secondary hypertension. Secondary hypertension is more common in younger children, while primary hypertension is more prevalent in obese adolescents. High-yield investigations include kidney ultrasound (to detect renal causes), lipid profiles (especially in overweight/obese children), and echocardiograms (to assess for target-organ damage). A simplified workup is recommended for all hypertensive children, with further testing guided by initial results for cost-effective management .

Emerging and Noninvasive Diagnostic Tools

New technologies are being explored to improve hypertension diagnosis. Automated diagnostic tools using electrocardiogram (ECG) signals and deep learning algorithms have shown high accuracy in detecting hypertension, offering a noninvasive and efficient alternative for hospital settings. Additionally, several hematological parameters, such as neutrophil to lymphocyte ratio (NLR), monocyte to HDL cholesterol ratio (MHR), and red cell distribution width (RDW), are being studied as inexpensive and easily accessible biomarkers for early screening and risk stratification in hypertension 67.

Diagnostic Testing Performance and Access

In low- and middle-income countries, a significant proportion of individuals who meet criteria for hypertension testing are not being tested, with disparities based on sex, wealth, and education. Improving adherence to risk-factor-based testing guidelines, rather than relying on sociodemographic characteristics, is essential for better hypertension detection and management .

Conclusion

Diagnosing hypertension relies on accurate BP measurement, with ABPM and HBPM recommended to confirm clinic findings. Laboratory and biochemical tests are crucial for identifying secondary causes, comorbidities, and organ damage. In children, targeted diagnostic workups are necessary. Emerging noninvasive tools and hematological biomarkers show promise for future screening and diagnosis. Addressing disparities in diagnostic testing access remains a key challenge for global hypertension control.

Sources and full results

Most relevant research papers on this topic

Diagnostic testing for hypertension, diabetes, and hypercholesterolaemia in low-income and middle-income countries: a cross-sectional study of data for 994 185 individuals from 57 nationally representative surveys

In low-income and middle-income countries, diagnostic testing for cardiovascular risk factors is often not targeted and adherence to guidelines is low, with women, higher wealth, and education levels being more likely to be tested.

Observational Study

2023·

10citations

·Sophie Ochmann et al.

Noninvasive Diagnostics for Portal Hypertension: A Comprehensive Review

Noninvasive diagnostics for portal hypertension show promise for predicting clinically significant hypertension and monitoring changes in hepatic venous pressure gradient response to treatments.

Literature Review

2020·

54citations

·M. Mandorfer et al.

Yield of diagnostic testing in evaluating etiology and end organ effects of pediatric hypertension

A simplified secondary hypertension workup should include kidney ultrasound, lipid profile for overweight/obese children, and echocardiograms for assessing target-organ damage in hypertensive children.

Observational Study

2023·

5citations

·Fan Ding et al.

Blood pressure checks and diagnosing hypertension (BP-CHECK): Design and methods of a randomized controlled diagnostic study comparing clinic, home, kiosk, and 24-hour ambulatory BP monitoring.

BP-CHECK is a randomized controlled study comparing clinic, home, and kiosk-based blood pressure monitoring to 24-hour ambulatory BP monitoring for diagnosing hypertension.

RCTLarge Human TrialRigorous Journal

2019·

14citations

·B. Green et al.

Laboratory medicine in arterial hypertension

Laboratory medicine plays a crucial role in diagnosing and monitoring arterial hypertension, with antihypertensive drugs potentially affecting test results.

2023·

3citations

·M. Aralica et al.

Automated diagnostic tool for hypertension using convolutional neural network

The developed automated diagnostic tool using ECG signals achieves a high classification accuracy of 99.99%, making it useful in hospital settings for effortless detection of hypertension.

2020·

37citations

·Desmond Chuang Kiat Soh et al.

The Predictive Role of Hematological Parameters in Hypertension

Hematological parameters, such as neutrophil to lymphocyte ratio and platelet to lymphocyte ratio, have diagnostic and prognostic value in predicting hypertension, aiding in early screening, risk stratification, and optimal management.

Systematic Review

2023·

10citations

·Xiangzhu Meng et al.

Diagnosis and management of hypertension in adults: NICE guideline update 2019.

The 2019 NICE guidelines recommend using out-of-office measurements for diagnosing hypertension, with ambulatory BP monitoring as the gold standard and home BP monitoring as an alternative.

Highly Cited

2020·

131citations

·N. Jones et al.

Hypertension: The role of biochemistry in the diagnosis and management.

Biochemical testing is crucial for diagnosing and managing hypertension, helping identify patients with treatable causes and tailoring treatment based on individual risk factors.

Highly Cited

2017·

72citations

·P. O'Shea et al.

Abstract 134: Blood Pressure Control And Hypertension Diagnosis Six Months After Completing Ambulatory Blood Pressure Diagnostic Testing

Most individuals with high blood pressure on screening and ambulatory blood pressure monitoring did not achieve adequate blood pressure control or receive a hypertension diagnosis within 6 months.

RCTVery Rigorous Journal

2022·

0citations

·B. Green et al.

Try another search

headache treatment options

dietary protein requirements

planet surface imaging

increasing HDL cholesterol levels

probiotic administration methods

side effects of high dose vitamin d supplementation