Which tests are used to evaluate hypertension?

• A. Measurement of cortisol, aldosterone and catecholamines in a 24-hour urine sample
• B. Renal ultrasound alone
• C. Chest CT only
• D. Complete blood count only

Answer: (A)

In hypertension evaluation, it’s important to look for secondary causes that can raise blood pressure. Measuring cortisol, aldosterone, and catecholamines in a 24-hour urine sample targets three key conditions: Cushing’s syndrome (high cortisol), primary hyperaldosteronism (high aldosterone with suppressed renin), and pheochromocytoma or catecholamine excess (elevated catecholamines/metanephrines). The 24-hour collection helps smooth out daily fluctuations and increases accuracy, making it a practical way to screen for these endocrine sources of high blood pressure.

The other options don’t focus on these potential causes. Renal ultrasound alone checks kidney structure but not hormonal drivers of hypertension. Chest CT isn’t a standard tool for evaluating blood pressure, and a complete blood count doesn’t reveal the hormonal or adrenal etiologies that can underlie secondary hypertension.