Renovascular hypertension (patient information)
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Renovascular hypertension |
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Renovascular hypertension On the Web |
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Risk calculators and risk factors for Renovascular hypertension |
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Raviteja Guddeti, M.B.B.S. [2]
Overview
Renovascular hypertension is high blood pressure due to narrowing of the arteries that carry blood to the kidneys. This condition is also called renal artery stenosis.
What are the symptoms of Renovascular hypertension?
People with renovascular hypertension may have a history of high blood pressure that is severe and hard to control with medication.
Symptoms of renovascular hypertension include:
- High blood pressure at a young age
- High blood pressure that suddenly gets worse or is difficult to control
- Kidneys that are not working well, which often occurs suddenly
- Narrowing of other arteries in the body, such as to the legs, the brain, the eyes and elsewhere
- Sudden buildup of fluid in the air sacs of the lungs (pulmonary edema)
If you have a severe headache, nausea or vomiting, bad headache, confusion, changes in your vision, or nosebleeds you may have a severe and dangerous form of high blood pressure called malignant hypertension.
What causes Renovascular hypertension?
When the arteries that carry blood to your kidneys become narrow, less blood flows to the kidneys. The kidneys mistakenly respond as if your blood pressure is low and make hormones that tell the body to hold on to more salt and water. This causes your blood pressure to rise.
Renal artery stenosis is a narrowing or blockage of the artery that supplies blood to the kidneys.
The most common cause of renal artery stenosis is a blockage in the the arteries due to high cholesterol. This problem occurs when a sticky, fatty substance called plaque builds up on the inner lining of the arteries. The plaque may slowly narrow or even block the renal (kidney) artery.
Risk factors for atherosclerosis include high blood pressure, smoking, diabetes, high cholesterol, heavy alcohol use, cocaine abuse, and increasing age.
Fibromuscular dysplasia is another cause of renal artery stenosis. It is often seen in women under age 50 and tends to run in families. It is caused by abnormal growth of cells in the walls of the arteries leading to the kidneys. This also leads to narrowing or blockage of these arteries.
Diagnosis
The health care provider may hear a "whooshing" noise, called a bruit, when placing a stethoscope over your belly area.
The following blood tests may be done:
- Cholesterol level
- Renin and aldosterone levels
- BUN - blood test
- Creatinine - blood test
- Potassium - blood test
- Creatinine clearance
Imaging tests may be done to see if the kidney arteries have narrowed. They include:
- Angiotensin converting enzyme (ACE) inhibition renography
- Doppler ultrasound of the renal arteries
- Magnetic resonance angiography (MRA)
- Renal arteriography