We present a case in which a 39-year-old woman with correctable bilateral renovascular hypertension did not show abnormality during post-captopril technetium-99m dimercaptosuccinic acid (DMSA) study. Post-captopril 99mTc-diethylene triamine penta-acetic acid (DTPA) scintigraphy revealed the adverse effect of a stenosis of the artery supplying the upper part of her left kidney but failed to uncover the existence of severe multiple narrowings of the right renal artery. After bilateral renovascular reconstructive surgery, the hypertension completely disappeared. This case illustrates that DTPA may be more efficacious than DMSA in the detection of segmental loss of renal function induced by angiotensin converting enzyme inhibition.

The occurrence of hypertension, leading to various life-threatening complications in the elderly is a widely recognized problem. The changes of body composition were determined in 120 control and untreated hypertensive subjects of various ages. In middle-aged hypertensive males, the total blood volume and plasma volume increased significantly compared to those of the healthy controls, while this increase was not significant in the case of hypertensive middle-aged females. In contrast, in the elderly hypertensive male subjects, the volume of all fluid components decreased, except the total body fat and the vascular volumes. There was a slight, statistically non-significant, increase in all the vascular volumes except in the red cell mass. The elderly hypertensive females showed the same tendency compared to the healthy controls of the same age. The vascular compartments seem to be decreased in elderly males, compared to those of the middle-aged males, while slightly increased in elderly females.