| Disorder | Suggestive clinical features |
| General | Severe or resistant hypertension |
| An acute rise in blood pressure over a previously stable value | |
| Proven age of onset before puberty | |
| Age less than 30 years with no family history of hypertension and no obesity | |
| Renovascular disease | An acute elevation in serum creatinine of at least 30% after administration of ACE inhibitor or ARB |
| Moderate to severe hypertension in a patient with diffuse atherosclerosis, a unilateral small kidney, or asymmetry in renal size of more than 1.5 cm that cannot be explained by another reason | |
| Moderate to severe hypertension in patients with recurrent episodes of flash pulmonary edema | |
| Onset of stage II hypertension after age 55 years | |
| Systolic or diastolic abdominal bruit (not very sensitive) | |
| Primary renal disease | Elevated serum creatinine concentration |
| Abnormal urinalysis | |
| Oral contraceptives | New elevation in blood pressure temporally related to use |
| NSAIDs | |
| Stimulants (eg, cocaine, methylphenidate) | |
| Calcineurin inhibitors | |
| Antidepressants | |
| Pheochromocytoma | Paroxysmal elevations in blood pressure |
| Triad of headache (usually pounding), palpitations, and sweating | |
| Primary aldosteronism | Unexplained hypokalemia with urinary potassium wasting; however, more than one-half of patients are normokalemic |
| Cushing's syndrome | Cushingoid facies, central obesity, proximal muscle weakness, and ecchymoses |
| May have a history of glucocorticoid use | |
| Sleep apnea syndrome | Common in patients with resistant hypertension, particularly if overweight or obese |
| Loud snoring or witnessed apneic episodes | |
| Daytime somnolence, fatigue, and morning confusion | |
| Coarctation of the aorta | Hypertension in the arms with diminished or delayed femoral pulses and low or unobtainable blood pressures in the legs |
| Left brachial pulse is diminished and equal to the femoral pulse if origin of the left subclavian artery is distal to the coarct | |
| Hypothyroidism | Symptoms of hypothyroidism |
| Elevated serum thyroid stimulating hormone | |
| Primary hyperparathyroidism | Elevated serum calcium |