Symptoms:

Usually, high blood pressure causes no symptoms. Occasionally you may have a mild headache. If your headache is severe, or if you have any of the symptoms below, see a doctor right away. These may be a sign of malignant hypertension.

• Blood in urine
• Confusion
• Crushing, angina-like chest pain
• Ear noise or buzzing
• Irregular heartbeat
• Nosebleed
• Tiredness
• Vision changes

Signs and tests:

Persons with renovascular hypertension usually have severe, difficult-to-control high blood pressure. Elevated blood pressure measurements, repeated over time, confirm hypertension.

Your doctor may hear a "whooshing" noise, or bruit, when placing a stethoscope over your belly area.

Other signs of this disease include:

• Episodes of heart failure (flash pulmonary edema)
• Rapid progression of kidney failure
• Acute kidney failure occurs when starting blood pressure medicines called ACE-I or ARBs
• Hypertension in an elderly patient whose blood pressure was previously well controlled

There may be signs of complications, such as:

• Left ventricular hypertrophy (swelling of the heart)
• Hypertensive retinopathy

Your doctor may order blood tests to check your renin and aldosterone levels. Imaging tests may be done see if the kidney arteries have narrowed. They include:

• Renal arteriography
• Doppler ultrasound of the renal arteries
• Magnetic resonance angiography (MRA)
• Angiotensin converting enzyme (ACE) inhibition renography