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Tests and diagnosis
By Mayo Clinic staffTo 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. 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.
- Onusko E. Diagnosing secondary hypertension. American Family Physician. 2003;68;67.
- Sutters M. Systemic hypertension. In: McPhee SJ, et al. Current Medical Diagnosis and Treatment. 49th ed. New York, N.Y.; McGraw-Hill Medical: 2010. http://www.accessmedicine.com/content.aspx?aID=3177080. Accessed July 9, 2010.
- Chobanian AV, et al. Seventh report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. National Heart, Lung, and Blood Institute. http://www.nhlbi.nih.gov/guidelines/hypertension/jnc7full.pdf. Accessed July 9, 2010.
- Domino FJ, et al. Overview of hypertension in adults. http://www.uptodate.com/home/index.html. Accessed June 23, 2010.
- Chiong JR, et al. Secondary hypertension: Current diagnosis and treatment. International Journal of Cardiology. 2008;124;6.
- Kiani J, et al. Medicinal importance of grapefruit juice and its interaction with various drugs. Nutrition Journal. 2007;6;33.
- 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 July 9, 2010.
- Sheps S (expert opinion). Mayo Clinic, Rochester, Minn. July 12, 2010.
- Dietary Guidelines for Americans, 2010. U.S. Department of Health and Human Services. http://www.cnpp.usda.gov/DGAs2010-PolicyDocument.htm. Accessed Feb. 18, 2011.
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