Classification of hypertension

Abstract

A 37-year-old Caucasian man is seen in your office for routine physical examination. He is unaware of any medical problems but notes that he has gained approximately 25 pounds in the past year. He has a strong family history of hypertension, diabetes mellitus type II, and coronary artery disease. His physical exam shows an overweight man in no distress. His height is 71 in., weight 200 pounds, BMI 28. Waist circumference is 40 in. Blood pressure is 138/87, pulse 80/min, respiratory rate 12, and temperature 98.6 F orally. His general examination is unremarkable. He has no arteriolar changes on funduscopic examination, no bruits; cardiac exam shows no displacement of the point of maximal impulse and no gallop. Screening laboratory studies are completely normal including fasting blood sugar, electrolytes, kidney function, and urinalysis.