title: Problem cases in renovascular hypertension.
abstract: The clinical course and response to therapy of 16 patients with various complex forms of renovascular hypertension were investigated. Reconstructive surgery and/or transluminal dilatation was either ineffective (n = 5) or could not be performed for technical reasons (n = 11). The group contained 7 patients with multilocular fibromuscular disease involving both renal arteries, two cases with multiple arteriosclerotic vascular occlusions, 3 patients with branch renal artery aneurysms, 3 with renal artery stenosis in a solitary kidney and one patient with renal artery stenosis and contraction of the contralateral kidney due to a non-vascular cause. With antihypertensive treatment, particularly with the angiotensin converting enzyme inhibitor captopril (n = 7), blood pressure could be reduced from 214 +/- 40/124 +/- 23 mm Hg to 145 +/- 23/88 +/- 9 mm Hg (P less than 0.001). In 11 of the 16 patients (69%) the values decreased to less than 160/95 mm Hg. These results suggest that, in complex forms of renovascular hypertension, antihypertensive treatment may be a potent therapeutic alternative if surgery and/or transluminal dilatation can not be performed or seem to have too high a risk.
mesh_terms: D000328:Adult; D000368:Aged; D000783:Aneurysm / Q000503:physiopathology; D000800:Angioplasty, Balloon; D000959:Antihypertensive Agents / Q000627:therapeutic use; D001161:Arteriosclerosis / Q000503:physiopathology; D001794:Blood Pressure; D001807:Blood Vessel Prosthesis; D002648:Child; D005260:Female; D005352:Fibromuscular Dysplasia / Q000503:physiopathology; D005500:Follow-Up Studies; D006801:Humans; D006977:Hypertension, Renal / Q000628:therapy*; D006978:Hypertension, Renovascular / Q000209:etiology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D012077:Renal Artery; D012078:Renal Artery Obstruction / Q000503:physiopathology
chemical_list: D000959:Antihypertensive Agents