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Renovascular hypertension: a noninvasive screening approach using captopril renography
1Department of Radiology, University of North Carolina Hospitals, Chapel Hill 27599, USA.
Insights
Captopril renography offers a reliable, noninvasive screening method for renovascular hypertension, achieving over 90% diagnostic accuracy. This cost-effective approach is crucial for identifying high-risk hypertensive patients, particularly those with fibromuscular dysplasia.
Area of Science:
- Nephrology
- Radiology
- Internal Medicine
Background:
- Renovascular hypertension screening is needed for cost-effective patient management.
- Current screening methods like angiography are invasive and expensive.
- Noninvasive diagnostic tools are desirable for this rare condition.
Purpose of the Study:
- To identify a reliable noninvasive screening test for renovascular hypertension.
- To evaluate the efficacy and cost-effectiveness of diagnostic approaches.
Main Methods:
- Conducted a MEDLINE search (1985-1994) using keywords: renovascular hypertension, noninvasive, screening.
- Reviewed 16 references and additional relevant literature.
- Focused on identifying a dependable noninvasive screening test.
Main Results:
- Captopril renography identified as the most reliable noninvasive screening test.
- Achieved diagnostic accuracy greater than 90% for renovascular hypertension.
- Cost-effectiveness depends on selecting high-risk patients.
Conclusions:
- Captopril renography is the leading noninvasive diagnostic tool for renovascular hypertension.
- Accurate diagnosis aids in timely and appropriate treatment.
- Fibromuscular dysplasia patients, often young women, show the best treatment outcomes.
Background:
Noninvasive cost-effective screening of hypertensive patients for renovascular hypertension is a desirable approach to a rare disorder. Currently many patients are screened with angiography, which is both invasive and expensive.
Methods:
A MEDLINE search from 1985 through July 1994 using the key words "renovascular hypertension," "noninvasive," "screening" generated 16 references. We reviewed these references, as well as several additional references, in an effort to find a reliable noninvasive screening test for renovascular hypertension.
Results And Conclusions:
To date, the most reliable noninvasive screening test for renovascular hypertension is captopril renography. Results of captopril renography allow the physician to diagnose renovascular hypertension with an accuracy of greater than 90 percent. Cost-effectiveness requires appropriate selection of high-risk hypertensive patients for subsequent investigation with captopril renography. Hypertensive patients who have fibromuscular dysplasia, which is most commonly found in young white women, have the best treatment outcomes.