Renovascular hypertension is due to obstructions in renal arteries, which carry blood to the kidneys. In premenopausal women, renovascular hypertension may be caused by fibromuscular dysplasia—an abnormal cell buildup in the artery walls.
Causes of Renovascular Hypertension
Many different conditions, including atherosclerosis, can narrow the renal arteries. As blood flow to the kidneys is reduced, they respond in the same way they would to a drop in blood pressure—by excreting hormones that trigger salt and water retention. Blood pressure rises in response.
Symptoms of Renovascular Hypertension
Blood pressure is likely to increase suddenly and efforts to lower it may fail, even with three or more medications. In fact, treatment with an ACE inhibitor may lead to sudden kidney failure.
Diagnosing Renovascular Hypertension
Angiography, either using MRI or catheters to examine the renal arteries, can reveal the obstructions responsible.
Treating Renovascular Hypertension
Most cases can be treated with a minimally invasive renal artery angioplasty, which is similar to coronary angioplasty in that a balloon is inflated to open up the artery and a stent inserted to keep the artery open. In rare severe cases, a vascular surgeon will perform one of the following open procedures: an endarterectomy—the surgical removal of plaque—or a bypass, which creates a detour around the blocked portion of your artery.
Date Last Modified: January 21, 2011
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