Asymptomatic patients with sustained blood pressure >135/80 mm Hg should be screened for which condition?

Asymptomatic patients with sustained blood pressure >135/80 mm Hg should be screened for which condition?

• A. Hyperlipidemia
• B. Type 2 Diabetes Mellitus
• C. Renal Insufficiency
• D. Hypothyroidism

Answer: (D)

The key idea is recognizing that hypertension can be influenced by reversible thyroid problems. Hypothyroidism can raise systemic vascular resistance and worsen lipid abnormalities, contributing to higher blood pressure. Because it’s a treatable condition, screening for thyroid dysfunction with a simple TSH (often with free T4 if needed) is a reasonable part of evaluating someone with sustained, asymptomatic hypertension. If hypothyroidism is found, thyroid hormone replacement can improve not only symptoms but also lipid levels and blood pressure control, addressing a factor that otherwise perpetuates cardiovascular risk. That makes screening for thyroid disease a meaningful step in this context. Hyperlipidemia and type 2 diabetes are important cardiovascular risk factors to assess in hypertensive patients, but they are not targeted screening specifically because of the hypertension itself. Renal function is part of baseline HTN workup, but the question emphasizes a reversible endocrine cause as the focus of screening in this scenario.

The key idea is recognizing that hypertension can be influenced by reversible thyroid problems. Hypothyroidism can raise systemic vascular resistance and worsen lipid abnormalities, contributing to higher blood pressure. Because it’s a treatable condition, screening for thyroid dysfunction with a simple TSH (often with free T4 if needed) is a reasonable part of evaluating someone with sustained, asymptomatic hypertension.

If hypothyroidism is found, thyroid hormone replacement can improve not only symptoms but also lipid levels and blood pressure control, addressing a factor that otherwise perpetuates cardiovascular risk. That makes screening for thyroid disease a meaningful step in this context.

Hyperlipidemia and type 2 diabetes are important cardiovascular risk factors to assess in hypertensive patients, but they are not targeted screening specifically because of the hypertension itself. Renal function is part of baseline HTN workup, but the question emphasizes a reversible endocrine cause as the focus of screening in this scenario.