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:

People with renovascular hypertension usually have severe, difficult-to-control high blood pressure. They may have a history of high blood pressure that is hard to control or does not get better with medication.

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

Other signs of this disease include:

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

There may be signs of complications, such as:

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

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

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