[Progression and severity of arterial hypertension in aged subjects (12 cases]

We analyzed retrospectively 12 patients, aged from 63 to 73 years, with renovascular hypertension due to unilateral or bilateral atheromatous lesions (4 out of 12). Malignant or accelerated hypertension with multiple visceral involvement was frequent (8 out of 12). The proximal lesions (stenosis) of the renal arteries were rapidly progressive, leading to complete thrombosis in 8 cases. Five patients received medical treatment only, but 2 worsened their GFR and 2 had a poor blood pressure control. Of the 5 patients who underwent renal surgery 2 had nephrectomy, 2 had an aorto-renal bypass and 1 a bypass plus nephrectomy; 2 of them recovered a normal GFR, but 2 died in the post-operative period. Three patients had selective embolization of a renal artery, but only one was definitely improved. So far, the treatment of such cases still is very difficult.