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Evidence-based blood tests for monitoring adults with hypertension in primary care: rapid review, routine data

Martha Maria Christine Elwenspoek1,2, Rachel O'Donnell2, Catalina Lopez Manzano2

  • 1The National Institute for Health Research Applied Research Collaboration West (NIHR ARC West), University Hospitals Bristol NHS Foundation Trust, Bristol, UK martha.elwenspoek@bristol.ac.uk.

The British Journal of General Practice : the Journal of the Royal College of General Practitioners
|January 6, 2026
PubMed

Insights

A minimal set of blood tests, including estimated glomerular filtration rate (eGFR) and glycated hemoglobin (HbA1c), is recommended for monitoring adults with hypertension. This aims to improve patient care and reduce unnecessary testing variations.

Area of Science:

  • Nephrology
  • Endocrinology
  • General Practice

Background:

  • Significant variation in hypertension testing rates in UK primary care indicates suboptimal patient monitoring.
  • A need exists for evidence-based guidelines on essential blood tests for hypertension management.

Purpose of the Study:

  • To establish a minimal, evidence-based panel of blood tests for monitoring adult hypertension.
  • To reduce unwarranted variation in diagnostic testing for hypertensive patients.

Main Methods:

  • A rapid review of evidence for 16 routinely ordered tests in hypertension.
  • A consensus study involving clinicians and patients to select tests based on evidence.
  • Analysis of primary care records and further reviews to resolve consensus disagreements.

Main Results:

  • Consistent evidence supports eGFR for chronic kidney disease and HbA1c for diabetes detection.
  • No or inconsistent evidence found for routine lipids, electrolytes, hemoglobin, thyroid, clotting, calcium, ferritin, folate, or vitamin B12 testing.
  • No benefit demonstrated for routine liver function, inflammation, or BNP monitoring.

Conclusions:

  • A minimal panel of eGFR, HbA1c, potassium, and sodium is identified for monitoring adults with hypertension.
  • Implementation can reduce harms from unwarranted testing variations.
  • Further research is needed for tests with inconsistent evidence and optimal testing frequency.
Abstract

Keywords:
blood testschronic diseasesevidence-based medicinehypertensionprimary health care

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