Before going to the hospital, many people have the same trouble – do not know what department they should be registered? Just like hypertension patients, they are always confused whether to register for cardiovascular medicine or neurology.
In fact, cardiovascular medicine is mainly for the treatment of cardiovascular lesions, while neurology is for neurological diseases. Hypertension is a typical disease of the cardiovascular system, so the correct answer is cardiovascular medicine, or cardiology for short.
Of course, with the progress of medicine in our country, the branches of medicine are becoming more and more refined, and many specialized medical institutions have set up separate specialties for hypertension, which is also available for consultation.
After choosing a department and registering, it is time to make an appointment.
When consulting a cardiologist, the doctor usually needs to complete the diagnosis in three steps, including establishing the diagnosis of hypertension and grading the blood pressure level, determining the cause of hypertension to distinguish primary or secondary hypertension, and giving a guiding diagnostic result and treatment direction.
To accomplish these tasks, the physician needs to interact with the patient and ask questions about the patient’s disease history in order to obtain a sufficiently detailed diagnosis.
1. It is important to inform the medical history
The history of the disease covers family history, duration of the disease, conscious symptoms, history of previous diseases, history of treatment, and lifestyle.
Asking medical history
(1) Family history: Ask if the patient has a family history of hypertension, stroke, diabetes, dyslipidemia, coronary heart disease or kidney disease, and if so, further determine the age of onset.
(2) Course of disease: Ask the patient when the abnormal blood pressure was first detected in the first visit or when the diagnosis of hypertension was made in the established patient.
(3) History of previous diseases: Ask whether current and previous symptoms of stroke, cerebral ischemia, coronary artery disease, peripheral vascular disease, diabetes mellitus, gout, dyslipidemia, renal disease, etc. have occurred and their treatment.
(4) Treatment history: Ask whether antihypertensive drugs have been used, and if so, the type and dosage of drugs used in the past and currently, as well as their efficacy and whether they have been used as prescribed by the doctor.
(5) Clinical symptoms: Ask whether there are symptoms suspected of hypertension such as headache, dizziness, neck stiffness, palpitations or excessive nocturia, dyspnea, etc.
(6) Lifestyle: Ask about daily intake of salt, meat and other foods, and whether there are bad habits such as smoking, alcohol abuse, and long-term physical inactivity.
(7) Other aspects: Ask whether the patient has recently taken any medications that affect blood pressure, such as oral contraceptives, ephedrine, etc. Secondly, you need to understand the level of stress in the patient’s work life and determine whether he or she has a history of trauma.
Of course, the process of asking about hypertension is not a unilateral process, and every question mentioned by the doctor has a significant meaning behind it. Therefore, the patient needs to cooperate fully and avoid concealment.
2, answer the question must be clear
When the doctor asks about the family history, he or she is trying to understand the genetic factors. If the onset of the disease is too early and the correct intervention has not been made during the period, the possibility that some organs have been damaged cannot be ruled out.
In addition, the history of previous diseases and treatment is aimed at determining the underlying physical condition, the incidence of complications, and the effectiveness of drug therapy. Asking about clinical symptoms can help the doctor understand the progress of the disease to some extent. Some patients with hypertension may have more symptoms in the early stage due to the large fluctuation of blood pressure, while after a long period of hypertension, there may be no obvious symptoms even if the blood pressure level is high.
Inquiries about diet and lifestyle habits, as well as medications and mental status, are mainly to clarify the risk factors that trigger hypertension for precise avoidance in the later stages of treatment.
Patients should not give large vague information when answering the doctor’s questions, and try to give definite and accurate information points, which may otherwise hinder the diagnosis.
References
[1]Sun Ningling,Wu Haiying. Hypertension diagnosis and treatment routine 2012 edition [M]. Beijing China Medical Science and Technology Press,2015:58-59.
[2]. Guidelines for primary care treatment of hypertension (2019)[J]. Chinese Journal of General Practitioners,2019(04):301-313.
[3]Guidelines for the prevention and treatment of hypertension in China (2018 revised edition)[J]. Chinese Journal of Cardiovascular,2019,24(1):24-56.