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Hypertension Testing Overview:

In order to gauge your current state of health, our clinic will often request copies of your last two years of medical testing and will often recommend further testing as needed.  Our clinic does request some testing that is and not commonly performed in more "mainstream" medical clinics.  24-hour heavy metal testing with provoking agent, neurotransmitter analysis, food sensitivity testing, comprehensive stool testing and Candida antigen testing are commonly recommended by our medical staff.   Some of these are discussed in detail in the links in this section.

What to Expect on Your First Visit:

First office visits typically last 45-60 minutes.  Your doctor will review your intake form with you and gather a detailed medical history.  A partial physical exam is usually performed and medical records are often requested from your primary care physician and/or other doctors.  Specialty laboratory testing may be recommended.  Most clients are offered an initial protocol consisting of nutritional supplementation, dietary and life style recommendations.

First Visit: Blood Test

To assess and identify kidney, liver, blood sugar and other key factors such as blood cholesterols. The results are explained to the patient, giving him/her a fuller understanding of the blood chemistry, so that they may take control.

Patients are required to fast for 14 hours before the test. Water may be drunk freely, but not tea, coffee, juices or other beverages. Appointments are normally arranged for mid-morning so that food and drink can be consumed up to 8pm the previous evening. On the day of the appointment, any prescribed medication should be taken with water as normal.

Patients are recommended to bring food to eat after the blood sample has been taken. Diabetics should advise the clinic, and separate arrangements will be made.

First Visit: Urine Analysis

To establish exactly how the kidneys are functioning. Patients are required to collect urine over a period of 24 hours. This should be as near the date of the blood test as possible, but must not include the 14 hours fasting period prior to the appointment.

A recommended timetable is that the first urine of the day should be excluded, than all subsequent urine for the next 24 hours collected in clean plastic containers. (If collection starts at 8am, this process must be followed until 8am the following day.) Eg. Appointment 10am Friday, fasting commences Thursday 8pm. Urine collection starts Wednesday 8am. until Thursday 8am.

Containers should be clearly labeled with the patient’s names and brought to the clinic at the time of their appointment.

First Visit: Resting ECG for Doctors Report

The electrocardiograph (ECG) determines the condition of the heart and measures its actions and the pulse.

The doctor in charge reports any findings in his medical notes.

Specific Hypertension Testing:

High blood pressure (hypertension) means that your blood is pumping with more force than normal through your arteries. Unless you have your pressure checked, you won't know it's too high until it causes some serious damage. Over time, high blood pressure can wear down your circulatory system, leading to heart attacks, congestive heart failure, kidney failure, stroke, and even brain damage.

A. Electrocardiography

What is an Electrocardiography (ECG)?

Electrocardiography is a procedure that records and evaluates the electrical activities of the heart. During an electrocardiogram, patches called electrodes are attached to the skin of your arms, leg and chest. These electrodes are connected to a machine that traces your heart activity onto a piece of paper that will be later used by your physician for evaluation.

Indications and Contraindications

An electrocardiogram is done to measure the electrical activities of the heart in order to gives vital information on the current condition of your heart. The readings from an electrocardiogram determine the causes of various cardiovascular problems that you may be experiencing such as palpitations, abnormal heart rhythms, chest pain, shortness of breath, stroke, enlargement of the heart, and heart attacks. It also checks for the effectiveness of heart therapies, medications and surgery. An electrocardiogram is also used to measure stress.

Patients with the following conditions are also at risk for cardiovascular disease and will benefit from electrocardiogram assessment:

• Diabetes
• Obesity
• Renal failure
• Electrolyte abnormalities

How do you prepare for an ECG test?

There is no special preparation needed prior to the electrocardiogram test. However, if you are taking medications, inform your physician of the medicines that you take as this may alter the results of the electrocardiogram.

You may be asked to wear a gown during the test. Remove all jewelries and metallic items from your body before the test.

How does it feel? How long will it take?

The electrocardiogram test is safe and painless. You may feel that the disks of the electrodes are cold as soon as they are being attached to your chest. After the test, you may feel a slight pull when the electrodes are being removed. This procedure will last for 10-15 minutes, including attachment of electrodes to the body.

Expected effects after the test:

An electrocardiogram is safe and simple. It poses no harmful risks and is considered to be a standard test that is part of a complete physical examination. Normally, there are no effects from the electrocardiogram procedure. Chest pain during the procedure may be related to an arrhythmia on the EKG.

Special instructions after the test:

No special instructions after the test.

Interpretation of Results:

Normal: 60-100 beats/minute, consistent and even rhythm, tracing normal, wave deflections

Abnormal: less than 60 beats/minute, greater than 100 beats/minute; Abnormal results also include abnormal ECG/EKG tracing, abnormal heart rhythm and heart murmur.

Abnormal ECG results may indicate:

• Arrhythmia, dysrhythmia
• Acute myocardial infarction
• Myocardial ischemia
• Ventricular hypertrophy
• Pericarditis
• Conduction system disease
• Pulmonary embolus
• Electrolyte imbalance

Notes:

• In order to properly diagnose cardiovascular disease, complete physical examination, electrocardiogram results, medical history and symptoms of heart disease must all be evaluated.
• Results may be altered by factors such as: talking and moving during the test, drinking cold water and exercising before the test and loose attachment of the electrodes.

B. Total Cholesterol Test

Cholesterol is a type of fat that is part of all animal cells. It is essential for many of the body’s metabolic processes, including hormone and bile production, and to help the body use vitamin D. However, there’s no need to eat foods high in cholesterol. The body is very good at making its own cholesterol; you don’t need to help it along. In fact, too much cholesterol in your diet can lead to heart disease.

Cholesterol is a white and waxy substance. There are two types of cholesterol:

• Low density lipoprotein (LDL) cholesterol – called the ‘bad’ cholesterol because it goes into the bloodstream and clogs up your arteries.
• High density lipoprotein (HDL) cholesterol – called the ‘good’ cholesterol because it helps to take the ‘bad’ cholesterol out of the bloodstream.

What is Total Cholesterol testing?

A total cholesterol test is a series of blood tests that measures the bad and good cholesterol and triglycerides in the blood. The purpose of this test is to detect the patient’s risk for coronary heart disease, heart failure or stroke. It is done as a part of the lipid profile testing that checks for the LDL, HDL and triglycerides.

Indications and Contraindications:

A total cholesterol test should be done to patients who have a history of heart disease, high cholesterol, and diabetes. This test is important if you are on a high-cholesterol diet and are overweight.

This test should not be done on patients that have acute illness, heart disease, stress or are pregnant.

How do you prepare for the complete cholesterol testing?

The patient is required to fast for 9 to 12 hours and only water may be taken leading up to the test. This is to obtain a more accurate result. Coffee, tea, and other beverages such as alcohol or pop soda should be avoided within 24 hours before the testing. If you are taking contraceptive pills, the doctor may advise you to stop taking drugs a few days before the test as this may affect the test results.

How does it feel? How long will it take?

The total cholesterol test is a painless procedure that usually lasts for a few minutes, about three minutes or less. Some patients may feel a slight stinging pain while the needle is being inserted to draw blood. After the test, a small amount of throbbing might occur on the needle site.

Expected effects after the test:

Because patients fast leading up to the test, it is recommended to bring a light snack to eat after the test in case you become hungry. You may return to your normal activities and regular diet after the test.

Special instructions after the test:

After drawing blood, cover the needle site with a pressure wrap or a bandage.

Interpretation of Results:

• Normal/ Desirable: under 200 mg/dl
• Moderate/ Borderline: 200- 239 mg/dl
• High/ High Risk: above 240 mg/dl

• A high cholesterol value may be related to pregnancy, hypertension, myocardial infarction, atherosclerosis, high-cholesterol diet, enzyme deficiencies, hypothyroidism and diabetes.
• A low cholesterol value may be related to malabsorption, malnutrition, hyperthyroidism, cholesterol-decreasing medication, liver disease, sepsis and stress.

Notes:

Patients with high levels of cholesterol are recommended to adopt a low-cholesterol diet by avoiding foods high in saturated fat such as animal fats, dairy products, processed meats, and deep-fried foods. Increase intake of fruits and vegetables is highly advised. Engage in a healthy lifestyle by exercising, avoiding alcohol and smoking.

The Right Diagnosis and Treatment for Hypertension

Once the comprehensive review is completed for each patient, our doctors and our team of medical professionals will evaluate your diagnosis. At this point, our doctors will spend one on one time with you to interpret and explain your results. Together you will explore your goals and discuss your treatment plan options. These treatment plans can be implemented using multiple modalities such as medications, hormones, diet, supplements, behavior and lifestyle changes, and alternative therapies. Our doctors will prescribe a preventative and comprehensive treatment plan that is tailored to your needs and fits into your lifestyle.

Patients Medical’s Personal Approach to Hypertension

Our doctors and our team at Patients Medical will regularly monitor your progress and track the effectiveness of your program making adjustments if necessary. Our goal is to support you and advise you every step of the way.

We work in conjunction with your existing doctors. Any gaps between specialists are filled to ensure we support your overall health and well-being. While we treat serious medical conditions such as Alzheimer’s, Diabetes, Parkinson’s, Multiple Sclerosis, anxiety, depression, and heart disease; the primary objective of our staff is prevention and early detection of disease.

We are located at: Patients Medical PC, 800 Second Avenue, Suite 900 (Between 42nd & 43rd Street), Manhattan, NYC, New York, NY 10017.