| Disease / condition | Differential signs / symptoms | Differential tests |
| Drug (iatrogenic) hypertension | There may be signs of acute intoxication, withdrawal syndrome, addiction to cocaine or sympathomimetics. History of treatment with corticosteroids, oral contraceptives, sympathomimetics, herbal preparations (for example, tsimitsifugoy, capsaicin, Chinese conic, licorice), immunosuppressants (cyclosporine), erythropoietin, high-dose steroid, endothelial growth factor inhibitors (bevacizumab). | Toxicological examination can reveal the reception of prohibited substances. With excessive use of licorice - gipokaliemia in biochemical analysis of urine. |
| Chronic Renal Failure | Possible itching of the skin, swelling, increased fatigue, there may be changes in the daily volume of urination and the appearance of urine. | High level of creatinine in the blood plasma. At the general or common analysis of a blood it is possible to find out signs of an anemia of chronic diseases. Ultrasound examination (ultrasound) of the kidneys can show sclerotic changes in the kidneys or polycystosis. |
| Coarctation of the aorta | Different blood pressure on the upper and lower extremities. Absence of pulse on the femoral artery. | To confirm the diagnosis, computed tomography (CT), angiography, magnetic resonance imaging (MRI) are used. |
| Stenosis of the renal artery | Usually in young patients with hard-to-control hypertension. There may be a noise of the renal artery during auscultation. | Renal duplex ultrasound or magnetic resonance angiography of the renal arteries. |
| Obstructive sleep apnea | Usually in patients with obesity and drowsiness during the day, snoring or suffocation in a dream. | Polysomnography shows a night decrease in the saturation of blood with oxygen. |
| Hyperaldosteronism | Fatigue, headaches, muscle aches and spasms, a feeling of numbness and tingling in the limbs. The main symptoms are mild metabolic alkalosis, hypernatrium, potassium depletion, and an elevated fasting glucose level. | In the biochemical analysis of blood: hyperkalemia and hyponatremia. The ratio "renin-aldosterone" plasma: increased with primary hyperaldosteronism and decreased in the secondary. |
| Hypothyroidism | Dry skin, intolerance to cold, increased body weight, lethargy, goiter (growth of the thyroid gland), a tendency to depression. | Increased level thyrotropic hormone with primary hypothyroidism. |
| Hyperthyroidism | Heat intolerance, weight loss, hyperphagia, heart palpitations. | Reduced level thyrotropic hormone, an increased level of free thyroid hormones. |
| Hyperparathyroidism | Often there are no distinctive symptoms, but there may be kidney colic, abdominal pain, muscle weakness. | The level of parathyroid hormone is increased, the concentration of calcium is increased with primary hyperparathyroidism, lowered - in the secondary. It is possible to increase the level of alkaline phosphatase. |
| Cushing's Syndrome | Classical symptoms and signs include: weight gain, moon face, dorsoventral fat deposition, striae on the abdomen, tendency to hematoma. | Abnormal results of the suppression test with dexamethasone, the level of free cortisol in the daily urine and / or nighttime cortisol in the urine. |
| Pheochromocytoma | Paroxysms of hypertension, hot flashes, headache. | Elevated levels of vanillylmandelic acid, metanephrine and / or catecholamines in daily urine. |
| Acromegaly | Enlarged extremities and lower jaw. | Increased level of insulin-like growth factor-1 (IGF-1). Elevated levels of growth hormone in the plasma, not suppressed by glucose. |
| Collagenoses | Symptoms of systemic lupus erythematosus, rheumatoid arthritis, scleroderma, or vasculitis in the anamnesis. | General analysis of blood, autoantibodies (ANA, anti-DNA, ANCA), abnormal levels of complement. |
| Hypertension of pregnant women | It is defined after 20 weeks of gestation in previously normotensive patients. | In the case of pre-eclampsia, the release of albumin with a urine of 300 mg / L per day. |