Renovascular hypertension

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Hypertensive kidney

Renal hypertension; Hypertension - renovascular

Usually, high blood pressure causes no symptoms. Occasionally, you may experience a mild headache. If your headache is severe, or if you experience any of the symptoms below, see a doctor right away. These may be a sign of malignant hypertension.

• Tiredness
• Confusion
• Vision changes
• Crushing, angina-like chest pain
• Heart failure
• Blood in urine
• Nosebleed
• Irregular heartbeat
• Ear noise or buzzing

Certain signs and symptoms may point towards the diagnosis of renovascular hypertension. These include:

• Severe, difficult-to-control hypertension. Renovascular hypertension is often severely high and difficult to treat.
• A "whooshing" noise, or bruit, which may be heard when placing a stethoscope over the abdominal (flank) area.
• Episodes of heart failure (flash pulmonary edema).
• Rapid progression of kidney failure.
• Acute renal failure which occurs when starting ACE-I or ARB type medicines.
• Sudden aggravation of hypertension in an elderly patient whose blood pressure was previously well controlled.

Elevated blood pressure measurements, repeated over time, confirm hypertension.

There may also be signs of complications, such as:

• Left ventricular hypertrophy (swelling of the heart)
• Hypertensive retinopathy
• Presence of a bruit

Visualization methods to see artery narrowing (atherosclerosis or renal stenosis) include:

• Renal arteriography (injection of dye into the renal artery so that a narrowing of the artery can be seen on an x-ray)
• Doppler ultrasound of the renal arteries
• Magnetic Resonance Angiography (MRA)
• Angiotensin converting enzyme (ACE) inhibition renography

Blood tests may also be performed to check renin and aldosterone levels.

Review Date: 06/13/2005
Reviewed By: Nader Najafian, M.D., Associate Physician, Renal Division, Brigham & Women's Hospital, Instructor of Medicine, Harvard Medical School, Boston, MA. Review provided by VeriMed Healthcare Network.