Renovascular hypertension is high blood pressure that is caused by narrowing (stenosis) of one or both of the arteries, called the renal arteries, that supply blood to the kidneys. Narrowing of the renal arteries reduces blood flow to the kidneys. This is a potentially serious condition that requires care from your doctor.
Each kidney is capable of regulating the body’s blood pressure to assure that each organ has an adequate supply of oxygenated blood. This happens by activating a cascade of hormones known as the renin-angiotensin system.
Renal artery stenosis triggers the release of these hormones, which then becomes a cause for hypertension (high blood pressure). Since hypertension is a leading cause of strokes and heart attacks , this is a serious condition that requires diagnosis and treatment.
The Kidney and Its Main Blood Vessels
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There are many diseases that can cause narrowing of the renal arteries. The two most common causes are atherosclerosis and fibromuscular dysplasia.
A risk factor is something that increases your chance of getting a disease or condition. The following factors increase your chance of developing atherosclerosis or fibromuscular dysplasia, which are the leading causes of renovascular hypertension.
Because problems with the renal arteries develop slowly and worsen over time, and most people do not experience symptoms of high blood pressure, you may not notice any symptoms.
However, the following symptoms may be signs of renovascular hypertension. If you experience any one of them, talk to your doctor:
Your doctor will ask about your symptoms and medical history, and perform a physical exam. You likely will be referred to a doctor who is a kidney specialist (nephrologist). Your doctor may take multiple blood pressure measurements over time and conduct blood tests to help diagnose your condition.
If you have renovascular hypertension, your doctor may conduct any of the following tests to see the amount of narrowing in the kidney arteries:
Talk with your doctor about the best treatment plan for you. Treatment options include the following:
Your doctor will first prescribe medication to help control your blood pressure. Because responses to medications vary, your doctor will monitor your blood pressure frequently and may adjust the type, combination, and/or dose of medication. Types of high blood pressure medications (antihypertensives) include the following:
If you have severe, uncontrolled renovascular hypertension, your physician may suggest interventions to restore blood flow to the kidneys. Types of interventions include the following:
Society for Vascular Surgery
Canadian Cardiovascular Society
Venous Disease Coalition
Fenves AZ, Ram CV. Renovascular hypertension: clinical concepts. Minerva Med. 2006;97:313-324.
Renal artery stenosis. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated November 4, 2010. Accessed November 11, 2010.
Renal vascular disease. Patient UK website. Available at http://www.patient.co.uk/doctor/Renal-Vascular-Disease.htm. Updated October 30, 2008. Accessed November 11, 2010.
Renovascular conditions. Society for Vascular Surgery website. Available at http://www.vascularweb.org/_CONTRIBUTION_PAGES/Patient_Information/NorthPoint/Renovascular_Conditions.html. Accessed January 13, 2008.
Last reviewed May 2014 by Adrienne Carmack, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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