Table 4.

Investigations to exclude secondary hypertension.

BIHS Simplified Screening Protocol for all People with RH (non-specialist setting)
History, symptoms, physical examination and factors affecting adherence (see Table 5 and supplementary file)
Blood test including kidney function, liver enzymes, full blood count, calcium and TSH
Urine dipstick
ECG
Renal imaging (e.g., US) to detect renal scarring and other gross abnormalities
Exclude OSA
Further Investigations Where There is Clinical Suspicion of Secondary Hypertension (usually performed in Specialist Settings)
Renin/aldosterone and plasma/urinary metadrenalines
Urine sample for albumin:creatinine ratio and protein:creatinine ratio
24-h urinary collection for sodium and potassium
24-h urine cortisol/dexamethasone suppression test
Adrenal imaging (MRI/CT)
Assessment of renal vascularity (MRA, CTA)

OSA obstructive sleep apnoea, TSH thyroid stimulating hormone, US Ultrasound, MRI magnetic resonance imaging, CT Computed Tomography, MRA Magnetic Resonance Angiography, CTA Computed Tomography Angiography.