High Blood Pressure (Arterial Hypertension): Medical History

Medical history (history of illness) represents an important component in the diagnosis of hypertension (high blood pressure). Family History

• Do family members (eg, parents/grandparents) have hypertension?

Social history

• Is there any evidence of psychosocial stress or strain due to your family situation?

Current medical history/systemic history (somatic and psychological complaints).

• Have you taken blood pressure measurements yourself? If yes, indicate duration and level of previous elevated blood pressure readings.
• Do you snore? Do you feel tired during the day?
• Do you suffer from headaches and/or dizziness?
• Are you often nervous, irritable?
• Do you suffer from frequent nosebleeds?
• Have you ever experienced visual disturbances?
• Do you occasionally suffer from palpitations or heart palpitations?
• Do you have shortness of breath? If so, load-dependent or also at rest* ?
• Do you have occasional attacks of chest tightness* (chest pain* )?
• Do you occasionally have other symptoms such as:
  • Ringing in the ears?
  • Trouble sleeping?

Vegetative anamnesis including nutritional anamnesis.

• Are you overweight? Please tell us your body weight (in kg) and height (in cm).
• Do you eat a lot of salty food?
• Do you exercise regularly?
• Do you suffer from sleep disorders?
• Do you smoke? If yes, how many cigarettes, cigars or pipes per day?
• Do you drink alcohol? If yes, what drink(s) and how many glasses per day?
• Do you use drugs? If yes, what drugs (amphetamines, cocaine) and how often per day or per week?

Self history incl. drug history.

• Pre-existing conditions (hormonal disorders, kidney disease, diabetes mellitus (diabetes), dyslipidemia, heart failure/heart failure).
• Operations
• Allergies
• Pregnancy

Medication

• Adrenergics/adrenoceptor agonists (dipivefrin, epinephrine).
• Anesthetics (fentanyl, ketamine (contraindicated in arterial hypertension), naloxone, pentazocine).
• Analgesics
  • COX-2 inhibitors – celecoxib, etoricoxib,rofecoxib
  • Acetic acid derivatives – diclofenac
  • Non-acid analgesics (paracetamol)
  • Non-steroidal anti-inflammatory drugs (NSAIDs) – acetylsalicylic acid (ASA), coxibe, diclofenac, ibuprofen, indometacin, meloxicam, naproxen, piroxicam).
• Anorectic (appetite suppressant) – sibutramine.
• Antidepressants
  • Tricyclic antidepressants (amitriptyline, amitriptyline oxide, clomipramine, desipramine, doxepin, imipramine, opipramol, nortriptyline, trimipramine) [for long-term therapy].
• Antiglutamatergic drugs/NMDA (n-methyl-D-aspartate) receptor antagonists (memantine).
• Antisympathotonics (clonidine/rebound hypertension (for abrupt discontinuation)).
• Ergotamine
• Hormones
  • Adrenaline
  • Anabolic steroids
  • Androgens (testosterone, testosterone antate, testosterone undecaonate).
  • Erythropoietins (synonyms: erythropoietin, EPO) – Epoetin ß, Darbepoetin.
  • Glucocorticoids (betamethasone, budenoside, fluticasone, prednisolone) [mineralocorticoid hypertension; mineralocorticoid hypertension]
  • Estrogens (ovulation inhibitors, anticonceptives, oral) – combination estrogen and progestin drugs result in an average blood pressure increase of approximately 5-7 mmHg systolic and 2 mmHg diastolic (compared to a control population)
  • Thyroid hormones (levothyroxine in L-thyroxine).
  • Vasopressin (Terlipressin)
• Immunosuppressants – ciclosporin (cyclosporin A), leflunomide, methotrexate, MTX.
• Immunotherapeutics (fingolimod).
• Multi-tyrosine kinase inhibitor (vandetanib).
• Sympathomimetics
  • Adrenaline, etilefrin
  • Indirect sympathomimetics (“stimulants“) – methylphenidate, amphetamine.
• Cytostatic drugs (methotrexate, MTX).

Environmental history

• Bisphenol A (BPA) as well as bisphenol S (BPS) and bisphenol F (BPF).
• Lead – Increase in relative relative risk by 19% with each 15 μg/g increase in lead (RR 1.19; 95% confidence interval 1.01-1.41; p = 0.04); cumulative lead exposure measured at the vertical bone of the tibia is a risk factor for drug-resistant hypertensionNote: A potential source of lead may be drinking water from lead pipes.
• Cadmium
• Particulate matter (PM2.5) and other air pollutants (nitrogen dioxide (NO2))
• Carbon monoxide
• Pesticides (organophosphates)
• Thallium
• Nocturnal aircraft noise (living in flight path; 45 dB during the day and over 55 dB aircraft noise at night).
• Weather effects:
  • Extreme heat
  • Extreme cold
  • Hot summer
  • Severe winters

* If this question has been answered with “Yes”, an immediate visit to the doctor is required! (Data without guarantee)