Diagnosing Renovascular Hypertension

ABSTRACT

Diagnosing renovascular hypertension is complex. Definitive diagnosis can only be made in retrospect, when a hypertensive patient with renal artery stenosis improves following correction of the stenotic arterial lesion. Screening for renovascular hypertension in all hypertensive patients is impractical because of the low prevalence of the disease. However, the diagnosis is important because treatment can lead to potential cure. A select group of patients with clinical signs and symptoms suggesting renovascular hypertension need to be investigated further for the cause of their hypertension. A number of clinical tests help in screening patients that require further imaging tests. The tests designed for evaluating renovascular hypertension assess the functional and anatomic abnormalities. This article reviews various clinical and imaging techniques available for evaluating these patients. A description of each technique is followed by a discussion of its advantages and disadvantages. The authors also propose an algorithm for work-up of patients with a high probability of renovascular hypertension.

KEYWORD

Renovascular hypertension - renal artery stenosis

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