From the Guidelines
For patients with newly diagnosed hypertension, basic laboratory tests, including fasting blood glucose, complete blood count, lipid profile, serum creatinine with eGFR, serum sodium, potassium, calcium, thyroid-stimulating hormone, urinalysis, and electrocardiogram, should be obtained to facilitate CVD risk factor profiling and screen for secondary causes of hypertension. These tests are essential for identifying underlying causes of hypertension, assessing organ damage, and guiding treatment decisions 1.
Key Laboratory Tests
- Fasting blood glucose to assess glucose levels
- Complete blood count to check for anemia or infections
- Lipid profile to evaluate cardiovascular risk factors
- Serum creatinine with eGFR to assess kidney function
- Serum sodium, potassium, calcium to monitor electrolyte levels
- Thyroid-stimulating hormone to rule out thyroid disorders
- Urinalysis to screen for kidney damage and protein leakage
- Electrocardiogram to assess cardiac structure and function Optional tests, such as echocardiogram, uric acid, and urinary albumin to creatinine ratio, may provide additional information on target organ damage, but are not universally recommended for all patients with hypertension 1.
Rationale for Test Selection
The selection of laboratory tests is guided by the need to identify underlying causes of hypertension, assess organ damage, and guide treatment decisions. The basic laboratory tests listed above provide a comprehensive assessment of cardiovascular risk factors, kidney function, and electrolyte levels, and are recommended for all patients with newly diagnosed hypertension 1.
From the Research
Laboratory Tests for Hypertension
The following laboratory tests are indicated for patients with hypertension (elevated blood pressure):
- Serum chemistry tests, such as basic metabolic panel 2, 3
- Electrocardiogram (ECG) 2, 3
- Urinalysis 2, 3
- Chest radiograph 2, 3
- Complete Blood Count (CBC) 3
- Funduscopy 2
Rationale for Laboratory Tests
These laboratory tests are used to:
- Evaluate for target organ damage, such as kidney damage or heart disease 2, 4
- Assess for other cardiovascular risk factors, such as diabetes or dyslipidemia 4
- Monitor for potential side effects of antihypertensive medications 5
- Guide treatment decisions, such as the need for lifestyle modifications or medication adjustments 6, 5
Specific Patient Populations
For patients with severely elevated blood pressure, additional laboratory tests may be indicated, such as:
- Serum creatinine and estimated glomerular filtration rate to assess renal function 5
- HDL, FBS, HbA1C, and serum uric acid to assess metabolic parameters 5
Limitations of Laboratory Tests
It is noted that routine testing for patients with asymptomatic severe blood pressure elevation in the emergency department may not always detect unanticipated hypertension-related abnormalities that alter ED management 3