Current Concepts in the Treatment of Renovascular Hypertension
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Renovascular disease (RVD) remains a major cause of secondary and treatment-resistant hypertension. Most cases are related either to fibromuscular or atherosclerotic lesions, but a variety of other causes including arterial dissection, stent occlusion, and embolic disease can produce the same syndrome. Recent studies emphasize the kidney’s tolerance to moderate flow reduction during antihypertensive drug therapy and the relative safety of medical therapy to control blood pressure. Several prospective trials in moderate RVD fail to identify major benefits from endovascular revascularization for moderate atherosclerotic disease. However, high-risk and progressive renovascular syndromes are recognized to be relatively refractory to medical therapy only and respond better to combining renal revascularization with ongoing medical therapy. Clinicians caring for complex hypertension should be familiar with pathogenic pathways, imaging techniques, and a rational approach to managing renovascular hypertension in the current era.
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Hypertension accelerated or worsened by renal artery stenosis remains among the most common causes of resistant hypertension, particularly in older age groups.
“Hypertension accelerated or worsened by renal artery stenosis remains among the most common causes of RH, particularly in older age groups.305”
From Resistant Hypertension: Detection, Evaluation, and Management: A Scientific Statement From the American Heart Association (2018) · cites this paper as [305]
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- Authors
- Herrmann, S. M., & Textor, S. C.
- Affiliations
- Mayo Clinic (US)
- Corresponding author
- Textor, Stephen C
- ORCID
- Herrmann, Sandra M
- Venue
- American Journal of Hypertension
- Publisher
- Oxford University Press (OUP)
- Published
- 2017-08-16
- Volume
- 31
- Issue
- 2
- Pages
- 139-149
- ISSN
- 0895-7061 (ISSN-L)
- 1941-7225
- PMC
- PMC5861545
- OpenAlex
- W2750164047
- Cited by
- 84
- References
- 78
- Citations by year
- 2026: 6 · 2025: 5 · 2024: 10 · 2023: 9 · 2022: 14 · 2021: 12 · 2020: 17 · 2019: 7 · 2018: 3 · 2017: 1
- FWCI
- 1.40
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- American Journal of Hypertension (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institutes of Health (UL1 RR024150)
- National Institute of Diabetes and Digestive and Kidney Diseases (R01 DK100081)
- Topics
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Renal and Vascular Pathologies
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Blood Pressure and Hypertension Studies
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Renin-Angiotensin System Studies
- Keywords
- renovascular hypertension, secondary hypertension, treatment-resistant hypertension, renal artery stenosis, fibromuscular dysplasia, atherosclerosis, renal revascularization, endovascular revascularization, antihypertensive therapy, renal blood flow, arterial dissection, stent occlusion, embolic disease
- MeSH terms
- Animals, Antihypertensive Agents, Blood Pressure, Humans, Hypertension, Renovascular, Renal Artery Obstruction, Risk Factors, Stents, Treatment Outcome, Endovascular Procedures
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