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A Bit of Heresy?

Ray W. Gifford Jr, MD
Arch Intern Med. 1978;138(8):1207. doi:10.1001/archinte.1978.03630330007003.
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Hypertension remains undetected and/or untreated in a large number of individuals, and the limited medical facilities, manpower, and resources that are available to evaluate these cases demand a critical reassessment of how much is really necessary in the pretreatment examination of the hypertensive patient.

These limitations have led to the discard of the intravenous pyelogram and tests for pheochromocytoma as routine examinations. Now, in this issue of Archives (p 1211), Bartha and Nugent present data from a retrospective review of the records of 116 hypertensive patients to indicate that routine roentgenograms of the chest and ECGs did not materially influence decisions on the management of hypertension in any case. Their conclusion was, "... the value of routine chest roentgenograms and ECGs cannot be defended on the basis of their contribution to the workup of hypertension."

It is important to distinguish those examinations that are pertinent to the diagnosis and/or management of


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