(2) Upon physical examination, the aortic second sound is accentuated and in elderly cases, metallic sound may be heard. Besides, there may be the fourth heart soumd and aortic early systolic ejection sound. In a case with prolonged hypertension, there appears left ventricular hypertrophy.

(3) Accelerated (malignant) hypertension progresses rapidly with a persistent DP greater than 17.3 kPa (130 mmHg), usually manifested as fundus bleeding or exudation, or edema of the optic disc. There may appear severe damage to the heart, brain and kidneys in a short time and even death.

(4) Routine urine examination: usually normal at the early stage, but when renal function is impaired, protein, erythrocyte, and cast, in occassional cases, may be found in the urine and the concentration of creatinine may increase

(5) Chest Xray may reflect the appearance and size of the heart, the change of the width and density (calcification) of the aorta. Echocardiogram is a reliable means to evaluate hypertrophy of the left ventricular. Besides electrocardiogram discloses the involvement of the heart (left ventricular hypertrophy, strain, ischemia and infarction) and arrhythmia, which are caused by high blood pressure.