[Rare forms of hypertension (neurofibromatosis and cholesterol embolization]

In the past year 5 patients with uncommon secondary hypertension have been observed at the Medical Clinic, Cantonal Hospital of St Gall, Switzerland. Two patients had generalized neurofibromatosis with specific vascular lesions of the renal arteries, while 3 older patients showed clinical and morphologic signs of repeated renal cholesterol embolization. Experience with these 5 patients shows that angiography should chiefly be used in young patients with suspected secondary hypertension. Older patients with common vascular sclerosis should undergo angiography only where the indication is urgent, in view of the risk of renal cholesterol embolization. In 3 of 5 patients a lasting improvement in hypertension was achieved by antihypertensive drug therapy. Two older patients with cholesterol embolization died from complications such as uremia and therapy-resistant hypertension.