[Significance of clinical anamnesis in the preliminary diagnosis of renovascular hypertension].
Differences in the occurrence of renovascular hypertension (RVH) in the population of patients with arterial hypertension related to different preselection criteria induced us to analyse practical usefulness of clinical anamnesis for RVH. In 130 patients with arterial hypertension (72 women, 58 men, average age 48 years) and clinical suspicion on RVH, the initial renal angioscintigraphy (with 99m Tc-DTPA) was abnormal, demonstrating impairment of glomerular filtration rate. In the whole group captopril angioscintigraphy test (CAT) as well as captopril renin test (CRT) were simultaneously performed according to own protocol. In 24 cases highly suspected for RVH on the ground of clinical anamnesis the critical stenosis of renal artery (> 75% of the lumen) was found in the arteriography. The most significant signs of RVH in clinical anamnesis were the following: the diastolic blood pressure > 120 mm Hg (92% cases), resistance to 3 hypertensive drugs (92%), sudden onset and rapidly progressive course of hypertension (88%) and advanced hypertension retinopathy (79%). On the ground of these results, detailed clinical anamnesis is recommended as a cheap and easy preselection test for RVH in the hypertensive population.
Smoszna
J
J
Kliniki Nefrologii ze Stacja Dializ Centralnego Szpitala Klinicznego Wojskowej Akademii Medycznej, Warszawie.
Wańkowicz
Z
Z
D000293:Adolescent; D000328:Adult; D000368:Aged; D000806:Angiotensin-Converting Enzyme Inhibitors; D002216:Captopril; D002985:Clinical Protocols; D005260:Female; D006801:Humans; D006978:Hypertension, Renovascular / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D012720:Severity of Illness Index; D013997:Time Factors
D000806:Angiotensin-Converting Enzyme Inhibitors; D002216:Captopril