Diagnosis

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 secondary hypertension based on only one higher than normal blood pressure reading. It may take three to six high blood pressure measurements at separate appointments to diagnose secondary hypertension. These measurements may come from home blood pressure monitoring and ambulatory blood pressure monitoring. With ambulatory blood pressure monitoring, a device takes blood pressure measurements automatically at specific times throughout the day.

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

• Blood tests. Blood tests are often done to check your levels of potassium, sodium, creatinine, blood glucose, and total cholesterol and triglycerides, among others.
• A urine test (urinalysis). Your doctor may want to check your urine for markers that could show that your high blood pressure is caused by another medical condition.
• Ultrasound of your kidneys. Many kidney conditions are linked to secondary hypertension. In this noninvasive test, a technician moves a small, hand-held device called a transducer over the area to be tested. The transducer sends sound waves into your body, collects the ones that bounce back and sends them to a computer, which creates images of your kidneys.

• Electrocardiogram (ECG or EKG). This painless noninvasive test records the electrical signals in your heart. You might have this test if your doctor thinks a heart problem might be causing your secondary hypertension.

  In this test, sensors (electrodes) are attached to your chest and sometimes to your limbs. Wires attach the electrodes to a computer. The computer records the heart's electrical signal information and displays it as waves on a monitor or on paper. This test can quickly reveal the timing and duration of each phase in your heartbeat.