Tests used to diagnose secondary high blood pressure

The following table lists the various tests used to confirm secondary high blood pressure and clarify its causes. Your doctor may use one or more of these tests for each condition depending on your individual situation.

Testing for secondary causes of high blood pressure

Secondary cause

Reasons to suspect

Test used to evaluate

Narrowing of the aorta (the artery that carries blood from your heart to the rest of your body)
  • High blood pressure accompanied by low pulse in the legs
Imaging of the aorta by one of the following:
  • CT angiography
  • Magnetic resonance angiography (MRA)
  • Angiogram
Hardening or narrowing of the arteries in your kidneys (renal artery stenosis)
  • High blood pressure at a young age, particularly in women
  • Severe problems with your blood vessels in other parts of your body
A test that clearly shows the structure of your renal arteries:
  • Ultrasound
  • Renal arteriogram
  • MRA
Hormonal imbalances
  • Diabetes
  • Obesity in the middle of your body
  • Facial swelling
  • Acne
  • Blood tests that show your hormone levels
Excess production of the hormone aldosterone, which regulates the salt and water balance in your kidneys
  • Low levels of potassium in your blood
  • Blood or urine tests that show your hormone and potassium levels
A tumor in your adrenal glands (located just above your kidneys)
  • Headaches
  • Fluttering in your heart
  • Flushing
  • Unstable blood pressure
  • Specific blood (hormone) and urine tests
  • Specialized imaging studies
High blood pressure caused by a new medication
  • You are taking a new medication.
  • Review of your medication list
  • Reevaluation of blood pressure when suspected agent is discontinued

High blood pressure caused by alcohol, cocaine, or amphetamines

  • You use cocaine, amphetamines, or excessive alcohol.
  • Reevaluation of blood pressure when suspected agent is discontinued

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