title: Optimal medical management in patients with renovascular hypertension.
abstract: Renovascular hypertension refers to the rise of arterial pressure due to reduced perfusion of the kidney caused by the stenotic renal artery/ies. The most common cause of stenotic renal artery is atherosclerosis. Atherosclerotic renal stenosis is usually part of a systemic syndrome that involves hypertension, intrinsic renal damage, and cardiovascular morbidity. So far, large trials have not proven the superiority of interventional therapies to medical management. As a result, renal artery stenosis should be treated mainly as a coronary artery disease equivalent focusing on rigorous management of hypertension, hyperglycemia, and hyperlipidemia. Antihypertensive treatment should include renin-angiotensin system blockade medication in most cases, while HMG-CoA reductase inhibitors (statins) can be used even in chronic kidney disease with safety. Lifestyle modifications, such as cessation of smoking, and antiplatelet therapy have reduced the risk of cardiovascular events in high-risk patients.
authors.affiliation: Department of Nephrology, University Hospital of Ioannina, and Department of Internal Medicine, Medical School, University of Ioannina, Ioannina, Greece. olgabalafa@gmail.com
authors.forename: Olga
authors.initials: O
authors.lastname: Balafa
authors.forename: Rigas
authors.initials: R
authors.lastname: Kalaitzidis
authors.forename: Kostas C
authors.initials: KC
authors.lastname: Siamopoulos
mesh_terms: D000959:Antihypertensive Agents / Q000009:adverse effects / Q000627:therapeutic use*; D050197:Atherosclerosis / Q000188:drug therapy* / Q000503:physiopathology; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000009:adverse effects / Q000627:therapeutic use*; D006978:Hypertension, Renovascular / Q000188:drug therapy* / Q000503:physiopathology / Q000628:therapy; D012078:Renal Artery Obstruction / Q000188:drug therapy* / Q000503:physiopathology; D012307:Risk Factors; D016896:Treatment Outcome
chemical_list: D000959:Antihypertensive Agents; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors