Long-term prognosis of renovascular hypertension: comparative study in operated and non-operated patients

Long-term prognosis of renovascular hypertension has been studied in 56 patients. Twenty-nine patients underwent surgical treatment and 27 patients were not operated upon for various reason. Initial severity of hypertension in the operated group was nearly comparable to that of the non-operated group. Average of observation periods in each group is 5.8 and 5.9 years respectively, and the longest follow-up period has been up to 12 years. Hypertension cured or improved in 25 cases of the operated group. Antihypertensive therapy was effective in 7 of the medically treated patients. During the entire observation periods, 2 cases of the operated and 10 cases of the non-operated group died. Seven deaths of the non-operated group seemed to be causally related to hypertension. It is concluded that long-term prognosis of operated patients is significantly improved as compared with that of patients whose renovascular hypertension could not be treated surgically. Prevelence of aortitis (Takayasu's disease) as a cause of renovascular hypertension is a particular problem in our series because extensive and complicated renovascular lesions may make surgical intervention difficult in some patients.