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What is renovascular hypertension? — Renovascular hypertension is a type of high blood pressure. It happens when the renal arteries, the blood vessels that carry blood to the kidneys, become narrow (figure 1).
High blood pressure puts you at risk for heart attack, stroke, and kidney disease. It does not usually cause symptoms. But it can be serious.
When your doctor or nurse tells you your blood pressure, they will say 2 numbers. For instance, your doctor or nurse might say that your blood pressure is "140 over 90." The top number is the pressure inside your arteries when your heart is contracting. The bottom number is the pressure inside your arteries when your heart is relaxed.
This table shows how doctors and nurses define high and normal blood pressure (table 1).
Renovascular hypertension is sometimes called "renal artery stenosis."
Will I need tests? — Maybe. If you have renovascular hypertension, your doctor might be able to hear a "whooshing" sound when listening to your belly through a stethoscope.
The doctor can also order imaging tests that create pictures of the renal arteries. But these tests are only done if the doctor thinks a procedure to open up the arteries could be helpful.
Should I see a doctor or nurse? — See your doctor or nurse right away if you have high blood pressure and get any of the following symptoms:
●A very bad headache
●Chest pain
●Severe pain in your upper back
●Problems breathing
●Weakness on 1 side of your body and not the other
●Problems speaking
●Nausea or vomiting
●Confusion
●Vision changes
●Blood in your urine
These can be signs of a very serious type of high blood pressure that needs to be treated as soon as possible.
How is renovascular hypertension treated? — Treatments include medicines for high blood pressure, such as:
●ACE inhibitors and ARBs – ACE inhibitors and ARBs are often grouped together, because they work in similar ways. These medicines can help prevent kidney disease.
Some examples of ACE inhibitors include enalapril, captopril, and lisinopril. Some examples of ARBs include candesartan (brand name: Atacand) and valsartan (brand name: Diovan).
●Diuretics – Some examples of diuretics include chlorthalidone, hydrochlorothiazide (also known as HCTZ), and furosemide (brand name: Lasix).
●Calcium channel blockers – Some examples of calcium channel blockers include amlodipine (brand name: Norvasc), felodipine (brand name: Plendil), and diltiazem (brand name: Cardizem). These medicines also help prevent chest pain caused by heart disease.
●Beta blockers – Some examples of beta blockers include atenolol (brand name: Tenormin), metoprolol (brand names: Lopressor, Toprol-XL), and propranolol (brand name: Inderal LA).
This article has only some basic information on these medicines. For more detailed information about your medicines, ask your doctor or nurse for the patient hand-out from Lexicomp, available through UpToDate. It explains how to use each medicine, describes its possible side effects, and lists other medicines or foods that can affect how it works.
Your doctor might recommend a procedure called "angioplasty" to open up 1 (or possibly both) of your renal arteries. During an angioplasty, the doctor puts a thin tube into a blood vessel in the leg and advances the tube to the kidney. Then the doctor inflates a tiny balloon inside the clogged artery to reopen it. Often the doctor props open the artery using a tiny mesh tube called a stent. Doctors only recommend angioplasty in certain situations.
Can renovascular hypertension be prevented? — You can reduce your chances of getting renovascular hypertension by keeping your blood vessels healthy. To do that, you should:
●Quit smoking, if you smoke.
●Walk, or do some form of physical activity on most days of the week.
●Lose weight, if you are overweight.
Patient education: High blood pressure in adults (The Basics)
Patient education: Coronary artery disease (The Basics)
Patient education: High blood pressure in adults (Beyond the Basics)
Patient education: High blood pressure treatment in adults (Beyond the Basics)
Patient education: High blood pressure, diet, and weight (Beyond the Basics)
