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Renovascular hypertension

C V Ram1, G P Clagett, L R Radford

  • 1Department of Internal Medicine and Surgery, University of Texas Southwestern Medical Center, Dallas 75235-8899, USA.

Seminars in Nephrology
|March 1, 1995
PubMed
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Renovascular hypertension, caused by renal artery stenosis, is often treated with revascularization. Surgical therapy offers the best long-term results for managing this condition.

Area of Science:

  • Nephrology
  • Cardiology
  • Hypertension Management

Background:

  • Renovascular hypertension is a common cause of secondary hypertension, but its prevalence is underestimated.
  • Advances in radiology have improved the clinical detection of renovascular hypertension.
  • Renal ischemia activates the renin-angiotensin system, leading to elevated blood pressure.

Purpose of the Study:

  • To review the causes, diagnosis, and management of renovascular hypertension.
  • To highlight the role of renal artery stenosis in blood pressure elevation.
  • To compare therapeutic options for renovascular hypertension.

Main Methods:

  • Review of pathological lesions causing renal artery stenosis (atherosclerosis and fibromuscular dysplasia).
  • Discussion of diagnostic work-up and screening for renovascular disease.

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  • Analysis of management strategies including medical therapy, balloon angioplasty, and surgical revascularization.

    • Main Results:

    • Atherosclerosis and fibromuscular dysplasia are the primary causes of renal artery stenosis.
    • Surgical revascularization provides superior long-term outcomes compared to balloon angioplasty.
    • Medical management is increasingly limited to specific patient groups.

    Conclusions:

    • Effective management of renovascular hypertension requires a multidisciplinary approach.
    • Reperfusion of the ischemic kidney is the ideal therapy to control blood pressure and prevent renal failure.
    • While balloon angioplasty is common, surgical intervention remains the gold standard for long-term results.