Renal and Renovascular Hypertension

  • Georges Mourad
  • Jean-Michel Halimi
  • Jean Ribstein
  • Albert Mimran

Abstract

Renal parenchymal disease and renovascular abnormalities are the most common causes of secondary hypertension. In clinical practice, a search for renal disease (i.e., proteinuria, abnormal urinary sediment, increased serum creatinine) should be undertaken in the presence of any newly diagnosed hypertension; however, only selected patients should be screened for renovascular disease. In recent years, the challenge in the management of patients with renal parenchymal disease has focused on the influence of strict control of hypertension on the rate of deterioration of renal function with time. In several experimental models, the use of antihypertensive agents has proved efficient in preventing the decline in renal function as well as the extent of glomerulosclerosis; interestingly, all antihypertensive medications were not equally effective in this regard. A number of questions remain unsettled in humans: Can adequate control of blood pressure slow down renal deterioration? Which drug should be used? What is the optimal level of arterial pressure? Although ischemic renovascular disease has recently emerged as an important cause of renal failure, the potential of revascularization to improve or preserve renal function is still a matter of debate.

Keywords

Propranolol Gout Furosemide Nephritis Atenolol 

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Copyright information

© Springer Science+Business Media New York 1998

Authors and Affiliations

  • Georges Mourad
    • 1
  • Jean-Michel Halimi
    • 1
  • Jean Ribstein
    • 1
  • Albert Mimran
    • 1
  1. 1.Medecine Interne et Hypertension ArtérielleCentre Hospitalier Universitaire, Hôpital LapeyronieMontpellier Cedex 5France

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