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Related Experiment Videos

Screening for renovascular hypertension.

N R Dunnick1, G N Sfakianakis

  • 1Department of Radiology, Duke University Medical Center, Durham, North Carolina.

Radiologic Clinics of North America
|May 1, 1991
PubMed
Summary
This summary is machine-generated.

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Renovascular hypertension, a curable cause of high blood pressure, requires careful screening. Diagnostic imaging, particularly with ACE inhibitor stimulation, aids in identifying renal artery stenosis and confirming renovascular hypertension for effective treatment.

Area of Science:

  • Nephrology
  • Cardiology
  • Radiology

Background:

  • Renovascular hypertension is the most common curable cause of high blood pressure, affecting a small percentage of hypertensive patients.
  • Clinical selection can identify a subgroup with a higher prevalence (approx. 15%) of renovascular hypertension, warranting further investigation.

Purpose of the Study:

  • To review current diagnostic modalities for renovascular hypertension.
  • To guide the selection of appropriate screening and diagnostic tests for renal artery stenosis.

Main Methods:

  • Discussion of various radiographic screening modalities including intravenous DSRA and radionuclide renogram with ACE inhibitor stimulation.
  • Evaluation of diagnostic accuracy and invasiveness of arteriography and intra-arterial DSRA.

Related Experiment Videos

  • Consideration of renin measurements for confirming renovascular hypertension.

    • Main Results:

    • Hypertensive urography is no longer recommended.
    • Intravenous DSRA and ACE inhibitor-stimulated radionuclide renograms show promise, with the latter being relatively noninvasive.
    • Arteriography and intra-arterial DSRA are reliable for detecting renal artery stenosis but are invasive.
    • Demonstrating increased renin production is key to confirming renovascular hypertension, though revascularization outcomes have been disappointing.

    Conclusions:

    • ACE inhibitor-stimulated radionuclide renography is often the most appropriate noninvasive examination.
    • Careful patient selection for screening is crucial.
    • Further refinements in diagnostic procedures, especially with stimulating drugs, are expected to improve diagnostic accuracy.