Diagnostic evaluation of hypertension: pilot study in a hypertension clinic

Two hundred and eighty-two (282) patients suffering from hypertension were evaluated for the detection of secondary forms of hypertension. Apart from clinical and routine laboratroy investigation in each, straight film of abdomen, intravenous pyelography (IVP), isotope renography and aortography were done in 174, 51, 109 and 2 cases respectively. Evidences of secondary hypertension was present in 22(7.8%) of which renal aetiology was probable in all but 4. Of the 10 patients with a primary kidney condition, possible renal aetiology was unsuspected in only one patient with unilateral renal hypoplasia. In 8 patients with renal involvement due to systemic disease, or in 4 with non-renal causes, the aetiological diagnosis was suggested by the clinical situation. In view of low yield of curable hypertension and high cost, IVP and renography should only be employed selectively and not as routine investigations.