RENOVASCULAR HYPERTENSION

RENOVASCULAR HYPERTENSION

Renovascular hypertension is high blood pressure that happens when the arteries that carry blood to the kidneys (renal arteries) become narrow. Blood pressure is a measurement of how strongly your blood is pressing against the walls of your arteries. Hypertension, or high blood pressure, is a long-term condition in which blood pressure is higher than normal.

Untreated hypertension, including renovascular hypertension, can lead to various health problems, such as:

  • Heart failure.
  • Heart disease.
  • Stroke.
  • Kidney failure.
  • Blood vessel damage.
  • Blindness or vision problems.

This condition occurs when one or both of the renal arteries become narrow. This narrowing reduces blood flow to the kidneys, causing the kidneys to sense that blood pressure is low. As a result, the kidneys make an enzyme called renin that causes an increase in blood pressure.

Many conditions can cause the renal arteries to become narrow and lead to renovascular hypertension. Some of these are:

  • This is a hardening of the renal arteries. It causes plaque to build up and block the renal arteries.
  • Fibromuscular dysplasia. This is a condition in which cells of the artery wall overgrow, causing a narrowing of the renal arteries. It is a common cause of renovascular hypertension in younger women.
  • A blockage in the renal artery due to injury, tumors, or blood clots (rare).

You are more likely to develop this condition if:

  • You are a woman who is younger than age 30.
  • You are a man who is older than age 50.
  • You have a history of heart problems or strokes.

In many cases, there are no symptoms. If symptoms are present, they may include:

  • Sudden high blood pressure that gets worse in older people who previously had well-controlled blood pressure.
  • Nausea and vomiting.
  • Vision problems.
  • Chest pain.

This condition may be diagnosed based on:

  • A physical exam and blood pressure check. During the exam, your health care provider may use a stethoscope to listen for a “whooshing” noise (bruit) over the abdomen or on either side between the ribs and the hip (flank area).
  • Blood tests to measure renin and to check your hormone levels, including a hormone called aldosterone. Aldosterone controls the salt and water balance in your body.
  • Imaging tests. These may include:
    • An ultrasound. This test uses sound waves to produce an image of the inside of your body.
    • Renal angiogram. For this test, a dye is injected into a kidney artery to show narrowing of the artery on an X-ray.
    • MRI of the arteries that supply the kidneys.

This condition may be treated with:

  • These may be given to help you control your blood pressure.
  • Treatments or lifestyle changes to address factors or conditions that may be contributing to high blood pressure. This may mean lowering your cholesterol, eating a heart-healthy diet, exercising, and maintaining an ideal body weight.
  • Surgery to remove a blockage. This may be necessary if a renal artery is blocked badly.
  • Percutaneous transluminal renal angioplasty (PTRA). This is a procedure to open narrow renal arteries if they are not completely blocked. Sometimes a stent is placed in the artery to prevent the artery from becoming blocked again.

Monitoring your blood pressure

  • Monitor your blood pressure at home as told by your health care provider.
    • A blood pressure reading is recorded as two numbers, such as 120 over 80 (or 120/80). The first (“top”) number is called the systolic pressure. It is a measure of the pressure in your arteries when your heart beats. The second (“bottom”) number is called the diastolic pressure. It is a measure of the pressure in your arteries as your heart relaxes between beats. A normal blood pressure reading is:
      • Systolic: below 120.
      • Diastolic: below 80.
    • Your personal target blood pressure may vary depending on your medical conditions, your age, and other factors.
  • Have your blood pressure rechecked as told by your health care provider.

Lifestyle

  • Work with your health care provider to maintain a healthy body weight or to lose weight. Ask what an ideal weight is for you.
  • Exercise regularly. Get at least 30–45 minutes of aerobic exercise, at least 5 times a week.
  • Do not use any products that contain nicotine or tobacco, such as cigarettes and e-cigarettes. If you need help quitting, ask your health care provider.

Eating and drinking

  • Eat a heart-healthy diet. This may include:
    • Following the DASH diet. This diet is high in fruits, vegetables, and whole grains. It is low in salt (sodium), saturated fat, and added sugars.
    • Keeping your sodium intake below 1,500 mg per day.Do not add salt to your food. Check food labels to see how much sodium is in a food or beverage.
  • Limit alcohol intake to no more than 1 drink a day for nonpregnant women and 2 drinks a day for men. One drink equals 12 oz of beer, 5 oz of wine, or 1½ oz of hard liquor.
  • Try to limit caffeine. Caffeine may make your renovascular hypertension worse. Check ingredients and nutrition facts to see if a food or beverage contains caffeine.

General instructions

  • Take over-the-counter and prescription medicines only as told by your health care provider.
  • Keep all follow-up visits as told by your health care provider. This is important.
  • Your symptoms continue to get worse and medicine does not help.
  • You have a fever.
  • You develop shortness of breath.
  • You develop numbness on one side.
  • You develop areas of muscle weakness.
  • You are unable to speak.
  • You feel light-headed or you pass out.
  • You have sudden spikes of high blood pressure.
  • You have symptoms of very high blood pressure.
  • Renovascular hypertension is high blood pressure that happens when the arteries that carry blood to the kidneys (renal arteries) become narrow.
  • In many cases, there are no symptoms for this condition.
  • There are several treatments for renovascular hypertension, including medicines, lifestyle changes, surgery to remove a blockage, or a procedure to widen a narrow artery.
  • Monitor your blood pressure at home as told by your health care provider.

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