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

Credits

Author	Robin Parks, MS
Editor	Kathleen M. Ariss, MS
Associate Editor	Pat Truman, MATC
Primary Medical Reviewer	Caroline S. Rhoads, MD - Internal Medicine
Specialist Medical Reviewer	Robert A. Kloner, MD, PhD - Cardiology
Specialist Medical Reviewer	Ruth Schneider, MPH, RD - Diet and Nutrition
Last Updated	April 24, 2007