Abstract
Renovascular hypertension (RVH) is one of the most frequent forms of secondary hypertension but this diagnosis is often missed because of insufficient care taken in collecting patient’s history and clinical signs. Herein we summarize the clinical, instrumental and laboratory clues which should raise the suspicion of RVH. In addition we briefly discuss the available evidence in favour and against the revascularization therapy and, at the light of the uncertain benefit of this procedure, the alternative approach with pharmacological treatment.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Bramlage P, Bohm M, Volpe M, Khan BV, Paar WD, Tebbe U, et al. A global perspective on blood pressure treatment and control in a referred cohort of hypertensive patients. J Clin Hypertens (Greenwich). 2010;12(9):666–77.
Ignatius J. “RR 160/80” Scipione Riva-Rocci (1863–1937). Duodecim. 1993;109(17):1493–4.
Prugger C, Keil U, Wellmann J, de Bacquer D, de Backer G, Ambrosio GB, et al. Blood pressure control and knowledge of target blood pressure in coronary patients across Europe: results from the EUROASPIRE III survey. J Hypertens. 2011;29(8):1641–8.
Chobanian AV. Shattuck Lecture. The hypertension paradox—more uncontrolled disease despite improved therapy. N Engl J Med. 2009;361(9):878–87.
Volpe M, Tocci G, Trimarco B, Rosei EA, Borghi C, Ambrosioni E, et al. Blood pressure control in Italy: results of recent surveys on hypertension. J Hypertens. 2007;25(7):1491–8.
Hartmann B, Weise H, Bassenge E. Quality assurance in Riva-Rocci blood pressure measurement: simultaneous sphygmomanometry with open and covered pressure display. Z Kardiol. 1988;77(8):537–42.
Volpe M, Rosei EA, Ambrosioni E, Cottone S, Cuspidi C, Borghi C, et al. 2012 Consensus Document of the Italian Society of Hypertension (SIIA): strategies to Improve Blood Pressure Control in Italy: from global cardiovascular risk stratification to combination therapy. High Blood Press Cardiovasc Prev. 2013;20(1):45–52.
Volpe M, Rosei EA, Ambrosioni E, Cottone S, Cuspidi C, Borghi C, et al. Renal artery denervation for treating resistant hypertension: definition of the disease, patient selection and description of the procedure. High Blood Press Cardiovasc Prev. 2012;19(4):237–44.
Mancia G, De Backer G, Dominiczak A, Cifkova R, Fagard R, Germano G, et al. 2007 ESH-ESC Practice Guidelines for the Management of Arterial Hypertension: ESH-ESC Task Force on the Management of Arterial Hypertension. J Hypertens. 2007;25(9):1751–62.
Mancia G, Laurent S, Agabiti-Rosei E, Ambrosioni E, Burnier M, Caulfield MJ, et al. Reappraisal of European guidelines on hypertension management: a European Society of Hypertension Task Force document. J Hypertens. 2009;27(11):2121–58.
Chobanian AV, Bakris GL, Black HR, Cushman WC, Green LA, Izzo JL Jr, et al. The seventh report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure: the JNC 7 report. JAMA. 2003;289(19):2560–72.
Mancia G, Fagard R, Narkiewicz K, Redon J, Zanchetti A, Bohm M, et al. 2013 ESH/ESC Guidelines for the management of arterial hypertension: The Task Force for the management of arterial hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). Eur Heart J. 2013;34(28):2159–219.
Hansen KJ, Edwards MS, Craven TE, Cherr GS, Jackson SA, Appel RG, et al. Prevalence of renovascular disease in the elderly: a population-based study. J Vasc Surg. 2002;36:443-51.
Morganti A, Marana I, Airoldi F, Alberti C, Nador B, Palatresi S. Renovascular hypertension. Clinical and diagnostic clues. Annales d’urologie. 1999;33(3):137–43.
Textor SC, Lerman L, McKusick M. The uncertain value of renal artery interventions: where are we now? JACC Cardiovasc Interv. 2009;2(3):175–82.
Burdick L, Airoldi F, Marana I, Giussani M, Alberti C, Cianci M, et al. Superiority of acceleration and acceleration time over pulsatility and resistance indices as screening tests for renal artery stenosis. J Hypertens. 1996;14(10):1229–35.
Morganti A. A comparative study on inter and intralaboratory reproducibility of renin measurement with a conventional enzymatic method and a new chemiluminescent assay of immunoreactive renin. J Hypertens. 2010;28(6):1307–12.
Mwipatayi BP, Beningfield SJ, White LE, Irish A, Abbas M, Sieunarine K. A review of the current treatment of renal artery stenosis. Eur J Vasc Endovasc Surg Off J Eur Soc Vasc Surg. 2005;29(5):479–88.
Wheatley K, Ives N, Gray R, Kalra PA, Moss JG, Baigent C, et al. Revascularization versus medical therapy for renal-artery stenosis. N Engl J Med. 2009;361(20):1953–62.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Lonati, C., Morganti, A. Clinical Management of Renovascular Hypertension. High Blood Press Cardiovasc Prev 20, 257–260 (2013). https://doi.org/10.1007/s40292-013-0023-2
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s40292-013-0023-2