Renal artery stenosis: a disease worth pursuing.
Consider renovascular hypertension (HT) when: Newly diagnosed hypertension presents with features that are atypical of essential hypertension; Resistant hypertension is associated with risk factors for atheroma; or Angiotensin-converting enzyme (ACE) inhibitor or angiotensin-II-receptor antagonist therapy is associated with increasing plasma creatinine levels. Atheromatous renovascular HT can often be managed medically, which includes intensive correction of cardiovascular risk factors. ACE inhibitors are probably second-line antihypertensives for patients with unilateral renal artery stenosis and two kidneys. First-line antihypertensives are diuretics, beta-blockers and calcium-channel blockers. Bilateral renal artery stenosis, or a unilateral stenosis in a patient with only one kidney, is an absolute contraindication to ACE inhibition.
Parker
S C
SC
Department of Medicine, University of Melbourne, Austin & Repatriation Medical Centre,  VIC.
Hannah
A
A
Brooks
M
M
Louis
W J
WJ
O'Callaghan
C J
CJ
D000792:Angiography; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000009:adverse effects / Q000627:therapeutic use; D000959:Antihypertensive Agents / Q000009:adverse effects / Q000627:therapeutic use; D003131:Combined Modality Therapy; D000075202:Contraindications; D003404:Creatinine / Q000097:blood; D006801:Humans; D006978:Hypertension, Renovascular / Q000175:diagnosis* / Q000188:drug therapy; D007677:Kidney Function Tests; D012078:Renal Artery Obstruction / Q000175:diagnosis* / Q000188:drug therapy
D000806:Angiotensin-Converting Enzyme Inhibitors; D000959:Antihypertensive Agents; D003404:Creatinine