Renovascular Hypertension

Abstract

Hypertension constitutes a major health problem and the challenge is to identify patients having 'surgically' curable renal vascular disease among the majority with so-called essential hypertension. The best of unsatisfactory diagnostic tests are renography and plasma renin activity both before and during angiotensin I1 blockade. The necessity of better screening tests has increased because of the recent advances in surgical techniques and especially percutaneous transluminal renal angioplasty. The latter has definitely become the method of choice for correction of suspected hemodynamically significant artery stenoses whenever technically feasible. With improved angioplasty techniques the risk of treating renal artery stenosis without hemodynamic and clinical importance (so-called cosmetic repair) has increased. Unfortunately randomized trials including surgery versus angioplasty are not available. It should be kept in mind that only after correction of the stenosis is achieved and the blood pressure has become normal, can the diagnosis of renovascular hypertension be made with certainty. 113 Acta Radiol Downloaded from informahealthcare.com by Nyu Medical Center on 02/06/15 For personal use only. genol. 135 (1980), 907. 9. BOOKSTEM J. J., ABRAMS H. L., BUENGER R. E. et coll.: Radiologic aspects of renovascular hypertension. Part 1. Aims and methods of the radiology study group. J. Amer. Med. Assoc. 220 (1972), 1218. 10. --et coll.: Radiologic aspects of renovascular hypertension. Part 2. The role of urography in unilateral disease. J. Amer. Med. Assoc. 220 (1972), 1225. 11. --et coll.: Radiologic aspects of renovascular hypertension. Part 3. Appraisal of arteriography.