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If your doctor finds your blood pressure is raised, you will probably have the following examinations:

checking your blood pressure at least twice during the first visit

feeling your pulse to see how regular and strong it is

checking pulses in your groin, feet and ankles to make sure your peripheral circulation is intact – pressing on the skin of your lower legs and then letting go will show how quickly blood flows back into the blanched area

feeling your chest to see where the tip of your beating heart is detectable – this gives a good indication of whether or not your heart is enlarged

listening to your heart with a stethoscope to check for heart murmurs and to listen to your heart beat rhythm

listening to your lungs to check for signs of fluid build-up on the chest

listening to your neck and abdomen with a stethoscope to detect any noises due to turbulent blood flow through damaged carotid or renal arteries

examining the backs of your eyes to look for any signs of arterial damage (see below).

If your blood pressure remains consistently raised, you may have the following routine investigations:

chest x-ray – to check the size and shape of the heart and to look for evidence of congestive heart failure with fluid build-up on the lungs

ECG – heart tracing to look for signs of left-ventricular thickening, irregular heartbeat or evidence that the heart muscle is struggling

analysis of a urine sample – to look for protein and sugar, which would suggest blood vessels in the kidney are damaged

blood test for urea and electrolytes – to check kidney function and your salt balance

blood test for fasting blood lipids – to see if your blood cholesterol or other fat levels are raised.

If your doctor suspects your blood pressure is due to an underlying cause, you may have one or more of the following tests carried out:

If your potassium level is low, and you are not on diuretic treatment, you may have a hormone problem leading to high blood pressure. You will therefore have blood tests taken to check levels of other hormones such as aldosterone, cortisol and renin.

Blood tests to assess kidney function (creatinine clearance rate).

An intravenous urogram – a substance that shows up on x-ray is injected into your blood stream and a series of x-rays taken. This shows any narrowing of your renal arteries, how well your kidneys concentrate the dye in the urine, and outlines your urinary system to show up anatomical abnormalities or shrinkage of the kidneys.

Ultrasound of your kidneys.

Blood tests to measure catecholamine levels or measurement of urinary vanillylmandelic acid if phaeochromocytoma (tumour of the adrenal gland) is suspected.

If acromegaly is suspected from changes to your facial features and the fact that your tongue, jaw, hands and feet are getting bigger, you will have your blood levels of growth hormone measured.