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, creatinine, fasting blood glucose, 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 arteries 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.

Sept. 09, 2016
  1. Textor S. Evaluation of secondary hypertension. http://www.uptodate.com/home. Accessed Jan. 6, 2015.
  2. Gilbert SJ, et al. Secondary hypertension. In: National Kidney Foundation Primer on Kidney Diseases. 6th ed. Philadelphia, Pa.: Elsevier/Saunders; 2014. http://www.clinicalkey.com. Accessed Jan. 6, 2016.
  3. Alpern RJ, et al. Physiology and pathophysiology of hypertension. In: Seldin and Giebisch’s The Kidney. 5th ed. Oxford: Academic Press; 2013. http://www.clinicalkey.com. Accessed Jan. 6, 2016.
  4. Poulter NR, et al. Hypertension. The Lancet. 2015;386:801.
  5. Viera AJ, et al. Diagnosis of secondary hypertension: An age-based approach. American Family Physician. 2010;82:1471.
  6. Overview of hypertension. Merck Manual Professional Version. http://www.merckmanuals.com/professional/cardiovascular-disorders/hypertension/overview-of-hypertension. Accessed Jan. 10, 2016.
  7. Faselis C, et al. Common secondary causes of resistant hypertension and rational for treatment. International Journal of Hypertension. 2011;236239.
  8. Hypertension diagnosis and treatment. Bloomington, Minn.: Institute for Clinical Systems Improvement. https://www.icsi.org/guidelines__more/catalog_guidelines_and_more/catalog_guidelines/catalog_cardiovascular_guidelines/hypertension/. Accessed Jan. 12, 2016.
  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. 15, 2016.
  10. Types of blood pressure medications. American Heart Association. http://www.heart.org/HEARTORG/Conditions/HighBloodPressure/PreventionTreatmentofHighBloodPressure/Types-of-Blood-Pressure-Medications_UCM_303247_Article.jsp#.Vpm1bfkrLIU. Accessed Jan. 15, 2016.
  11. Zaporowska-Stachowiak I, et al. Aliskiren – an alternative to angiotensin-converting enzyme inhibitors or angiotensin receptor blockers in the therapy of arterial hypertension. Archives of Medical Science. 2014;10:830.
  12. FDA drug safety communication: New warning and contraindication for blood pressure medicines containing aliskiren (Tekturna). http://www.fda.gov/Drugs/DrugSafety/ucm300889.htm. Accessed Jan. 15, 2016.
  13. Aliskiren. Micromedex Healthcare Series. http://www.micromedex.com. Accessed Jan. 15, 2016.
  14. 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. 15, 2016.
  15. Grapefruit. Natural Medicines Comprehensive Database. http://www.naturaldatabase.com . Accessed Jan. 15, 2016.
  16. Sheps SG (expert opinion). Mayo Clinic, Rochester, Minn. Jan. 17, 2016.
  17. Sheps SG. Who’s at risk? In: Mayo Clinic: 5 Steps to Controlling High Blood Pressure. 2nd ed. Rochester, Minn.: Mayo Foundation for Medical Education and Research (MFMER); 2015.