Renovascular hypertension

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Hypertensive kidney

Renal hypertension; Hypertension - renovascular

The first treatment step involves controlling the high blood pressure with medication.

Medications that may be used in an attempt to control blood pressure include diuretics, beta blockers, calcium channel blockers, angiotensin-converting enzyme inhibitors, angiotensin receptor blockers (ARBs) and alpha blockers.

Response to medications is highly individual. Blood pressure should be monitored frequently. Medication and dosage may need frequent adjustment.

Further management of the disease depends on its underlying cause. In some cases, surgical reconstruction of a damaged artery may be performed. Patients with fibromuscular dysplasia, a vascular disease that causes narrowing of the renal arteries, may benefit from percutaneous transluminal renal angioplasty (PRTA) using a stent. This cures hypertension in a good percentage of patients, and makes it easier to control in the rest.

Most nephrologists will attempt to a surgical bypass of the renal arteries (revascularization) to restore blood flow in patients who have severe, refractory hypertension, episodes of flash pulmonary edema or rapid progression of renal failure.

Renovascular hypertension in the elderly is a difficult clinical problem. It requires careful review and monitoring with frequent tests, sometimes invasive, to arrive at the best individualized solution, whether medical therapy or surgery.

• Early death
• Hypertensive heart disease
• Heart attack
• Congestive heart failure
• Blood vessel damage
• Kidney damage
• Kidney failure
• Stroke
• Loss of vision

Call for an appointment with your health care provider if hypertension is suspected.

Call your health care provider if renovascular hypertension has been diagnosed and symptoms occur, worsen, or do not improve with treatment. Also call if new symptoms develop.

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.