Renovascular Hypertension - Essay Example

Renovascular Hypertension Renovascular hypertension is defined as hypertension, an elevated blood pressure, caused by renal hypoperfusion. This usually is the result of blockage in the renal arteries that triggers and activates the renin-angiotensin system. As the blockage appears to the kidneys as low blood flow, the kidneys produce hormones that the body responds to by retaining salt and water. This salt and water retention in turn raise the body's blood pressure resulting in hypertension (diastolic pressure above 104) (Renovascular Hypertension 2006) Renovascular hypertension is termed secondary hypertension as it is caused by the activity in an isolated part of the body.

Renovascular hypertension may be also caused by malignant hypertension or renal artery stenosis. The most common cause of renovascular hypertension is artery stenosis, a narrowing of the artery pathway due to a buildup of plaque. The low blood flow to the kidneys results in an increase in the production of renin, which results in peripheral arteries to constrict and raising the body's blood pressure. Renovascular hypertension is evident in approximately 6 out of 100,000 people (Renovascular Hypertension 2006).

Age of onset varies depending on the cause but is most common in men over the age of 45 with atherosclerosis, and in women under the age of 45 with fibromuscular dysplasia (Renovascular Hypertension 2006). Children with fibromuscular dysplasia are at high risk as are people whose diets are high in salt, heavy metals, suffer stress, or have a family history of renovascular hypertension.A patient that has unusually high blood pressure for an extended time that is difficult to control should be suspect for renovascular hypertension.

In addition, the presence of abdominal, epigastric or flank bruit, a noticeable decrease in kidney size, or a recurrent pulmonary edema may also be noticed in a patient suffering from renovascular hypertension. Diagnosis may include observing the patients symptoms such as a resistance to 3 drug therapy, abdominal bruits, or "Worsening renal function during antihypertensive therapy, especially with ACEIs or angiotensin II receptor blockers" (Complete Summary 2007). In addition, testing may be required that will include renal arteriography, ultrasound, Magnetic Resonance Angiography (MRA), or Angiotensin converting enzyme (ACE) (Mushnick 2007).

Renovascular hypertension can be difficult to treat. Initially, one of the first recommendations will involve lifestyle. Weight control, exercise, and diet all contributors to renovascular hypertension. Medication may be successful in some cases, though treatment is very individual. Further treatment may involve the use of a catheter to enlarge the renal artery or in severe cases, bypass surgery may be required. In cases where the kidney has been damaged, kidney removal or transplant may be necessary.

When the diastolic pressure elevates above 104, the patient may have hypertension and there is a risk of renovascular hypertension. Hypertension that is uncontrollable by drug therapy warrants further research. It can be diagnosed with an MRA or invasive surgery. Treatment may be as simple as lifestyle changes or in a serious ailment could result in the loss of a kidney. Medicine has several drug and surgical procedures that can help treat the dangers of renovascular hypertension.Works Cited"Complete Summary.

" National Guideline Clearinghouse. 10 Sep. 2007. National Guideline Clearinghouse. 12 Sep. 2007 .Mushnick, Robert. "Renovascular Hypertension." Medical Encyclopedia. 6 Sep. 2007. National Institute of Health. 12 Sep. 2007 ."Renovascular Hypertension." Health and Disease Information. 31 Oct. 2006. Penn State College of Medicine. 12 Sep. 2007 .