Primary or essential hypertension is more common in adolescents and adults and has multiple risk factors, including obesity and a family history of hypertension. Laboratory tests can also be performed to identify possible causes of secondary hypertension, and to determine whether hypertension has caused damage to the heart, eyes, and kidneys. Additional tests for diabetes and high cholesterol levels are usually performed because these conditions are additional risk factors for the development of heart disease and may require treatment.Initial assessment of the hypertensive people should include a complete history and physical examination. Serum creatinine is measured to assess for the presence of kidney disease, which can be either the cause or the result of hypertension. Serum creatinine alone may overestimate glomerular filtration rate and recent guidelines advocate the use of predictive equations such as the Modification of Diet in Renal Disease (MDRD) formula to estimate glomerular filtration rate (eGFR). eGFR can also provide a baseline measurement of kidney function that can be used to monitor for side effects of certain anti-hypertensive drugs on kidney function. Additionally, testing of urine samples for protein is used as a secondary indicator of kidney disease. Electrocardiogram (EKG/ECG) testing is done to check for evidence that the heart is under strain from high blood pressure. It may also show whether there is thickening of the heart muscle (left ventricular hypertrophy) or whether the heart has experienced a prior minor disturbance such as a silent heart attack.
High blood potassium
Calcium gluconate is used as a cardioprotective agent in people with high blood potassium levels, with one alternative being the use of calcium chloride. It is recommended when the potassium levels are high (>6.5 mmol/L) or when the electrocardiogram (ECG) shows changes due to high blood potassium.Though it does not have an effect on potassium levels in the blood, it reduces the excitability of cardiomyocytes, thereby lowering the likelihood of cardiac arrhythmias. Magnesium sulfate overdose
It is also used to counteract an overdose of Epsom salts magnesium sulfate, which is often administered to pregnant women in order to prophylactically prevent seizures (as in a patient experiencing preeclampsia). Magnesium sulfate is no longer given to pregnant women who are experiencing premature labor in order to slow or stop their contractions (other tocolytics are now used instead due to better efficacy and side effect profiles). Excess magnesium sulfate results in magnesium sulfate toxicity, which results in both respiratory depression and a loss of deep tendon reflexes (hyporeflexia). Hydrofluoric acid burns
Gel preparations of calcium gluconate are used to treat hydrofluoric acid burns. The calcium gluconate reacts with hydrofluoric acid to form insoluble, non-toxic calcium fluoride. In addition to a 2.5% calcium gluconate gel being applied directly to the chemical burn, the person may also receive calcium gluconate supplements because the fluoride ion precipitates serum calcium, causing hypocalcemia. Cardiac arrest
While intravenous calcium has been used in cardiac arrest, its general use is not recommended.