诊断的思路晚近认为,高血压的诊断标准是成人血压>140/90(Meltzer,1983),对于一般轻～中度高血压的检查,除详细的询问病史和体检(包括眼底)外,一般仅需作尿常规(包括尿PH尿糖,尿比重),血钾、肌酐、胸透和心电图等实验检查。在有下述情况时,则应进一步排除继发性高血压:上述检查结果,提示有可能是继发性高血压;重度高血压(舒张压≥115mmHg);30岁以下或50岁以上开始发生高血压;对通常使用的降压药疗效不佳的高血压者。有些继发性高血压是比较容易辩认,很少误诊,但是,另一些继发性高血压在临床上很似原发性者,很容易误诊。要知道,有约10％的高血压是继发性的,而有些继发性高血压经手术治疗后,是可以治愈的。因而,作好鉴别诊断有重要意义。目前,仍有些 Diagnostic thinking It has been recently assumed that the diagnostic criteria for hypertension are> 140/90 in adults (Meltzer, 1983). For general mild to moderate hypertension, in addition to detailed medical history and physical examination (including fundus), generally only Need to be routine (including urine PH urine sugar, urine specific gravity), serum potassium, creatinine, chest and electrocardiogram and other laboratory tests. Secondary hypertension should be ruled out in the following circumstances: The above test results suggest that it may be secondary to hypertension; severe hypertension (diastolic blood pressure ≥ 115mmHg); below 30 years of age or 50 years of age or more began to occur Hypertension; commonly used antihypertensive drugs ineffective hypertension. Some secondary hypertension is relatively easy to identify, rarely misdiagnosed, but other secondary hypertension is clinically similar to primary, it is easy to misdiagnosis. You know, about 10% of hypertension is secondary, and some secondary hypertension after surgery, can be cured. Therefore, make a differential diagnosis of great significance. At present, there are still some