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Tests and diagnosis

By Mayo Clinic staff

To diagnose secondary hypertension, your doctor will first take a blood pressure reading using an inflatable cuff, just as your blood pressure is measured during a typical doctor's appointment. Your doctor may not diagnose you with secondary hypertension based on one higher than normal blood pressure reading — it may take three to six high blood pressure measurements at separate appointments to diagnose secondary hypertension.

Your doctor will also want to check other markers to pinpoint the cause of your high blood pressure. These could include:

  • A blood test. Your doctor may want to check your potassium, sodium, total cholesterol and triglycerides, and other chemicals in your blood to help make a diagnosis.
  • Urinalysis. Your doctor may want to check your urine for markers that could show your high blood pressure is caused by another medical condition.
  • Ultrasound of your kidneys. Since many kidney conditions are linked to secondary hypertension, your doctor may order an ultrasound of your kidneys and blood vessels. In this noninvasive test, a technician will run an instrument called a transducer over your skin. The transducer, which produces sound waves, measures how the sound waves bounce off your kidneys and sends images created by the sound waves to a computer monitor.
  • Electrocardiogram (ECG). If your doctor thinks your secondary hypertension may be caused by a heart problem, he or she may order an electrocardiogram. In this noninvasive test, sensors (electrodes) that can detect the electrical activity of your heart are attached to your chest and sometimes to your limbs. An ECG measures the timing and duration of each electrical phase in your heartbeat.
Treatments and drugs Preparing for your appointment
References
  1. McKean SC, et al. Principles and Practice of Hospital Medicine. New York, N.Y: The McGraw-Hill Companies; 2012. http://www.accessmedicine.com/resourceTOC.aspx?resourceID=749. Accessed Jan. 25, 2013.
  2. Sukor N. Secondary hypertension: A condition not to be missed. Postgraduate Medical Journal. 2011;87:706.
  3. Kaplan NM, et al. Overview of hypertension in adults. http://www.uptodate.com/home. Accessed Jan. 25, 2013.
  4. Fuster V, ed. et al. Hurst's The Heart. 13th ed. New York, N.Y.: The McGraw-Hill Companies; 2011. http://www.accessmedicine.com/resourceTOC.aspx?resourceID=5. Accessed Jan. 25, 2013.
  5. Lerma EV, et al. Current Diagnosis & Treatment: Nephrology & Hypertension. New York, N.Y.: The McGraw-Hill Companies; 2009. http://www.accessmedicine.com/resourceTOC.aspx?resourceID=628. Accessed Jan. 25, 2013.
  6. Viera AJ, et al. Diagnosis of secondary hypertension: An age-based approach. American Family Physician. 2010;82:1471.
  7. Grossman E, et al. Drug-induced hypertension: An unappreciated cause of secondary hypertension. The American Journal of Medicine. 2012;125:14.
  8. Sheps SG (expert opinion). Mayo Clinic, Rochester, Minn. Jan. 20, 2013.
  9. The seventh report of the Joint National Committee on Prevention, Detection, Evaluation and Treatment of High Blood Pressure. Bethesda, Md.: National Heart, Lung, and Blood Institute. http://www.nhlbi.nih.gov/guidelines/hypertension/jnc7full.htm. Accessed Jan. 20, 2013.
  10. Your guide to lowering your blood pressure with DASH. National Heart, Lung, and Blood Institute. http://www.nhlbi.nih.gov/health/public/heart/hbp/dash/new_dash.pdf. Accessed Jan. 20, 2013.
  11. Riccioni G. Aliskiren in the treatment of hypertension and organ damage. Cardiovascular Therapeutics. 2011;29:77.
  12. FDA drug safety communication: New warning and contraindication for blood pressure medicines containing aliskiren (Tekturna). U.S. Food and Drug Administration. http://www.fda.gov/Drugs/DrugSafety/ucm300889.htm. Accessed Jan. 22, 2013.
  13. Aliskiren. Micromedex Healthcare Series. http://www.micromedex.com. Accessed Jan. 22, 2013.
  14. Grapefruit. Natural Medicines Comprehensive Database. http://www.naturaldatabase.com. Accessed Jan. 22, 2013.
DS01114 March 15, 2013

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