scholarly journals Overview on Renovascular Hypertension: Review Article

2021 ◽  
pp. 15-22
Author(s):  
Mohammed Salah Hussein ◽  
Almutairi, Samia Nouh ◽  
Azam Mohammed Alnamy ◽  
Alsulami, Roaya Ayed ◽  
Zainab Ali Alshaikh ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Renovascular Hypertension ◽  
Antihypertensive Medication ◽  
Fibromuscular Dysplasia ◽  
Secondary Hypertension ◽  
Review Article ◽  
Systemic Hypertension ◽  
Atherosclerotic Renal Artery Stenosis ◽  
Medication Treatment ◽  
Ultimate Objective

Renovascular hypertension (RVH) is a prevalent cause of secondary hypertension that frequently develops to resistant hypertension. It is characterised as systemic hypertension that develops as a result of a restricted blood supply to the kidneys. Patients cannot be recognized clinically from those with essential hypertension; therefore, diagnosis requires arteriography, however urography and isotope renography may hint to the diagnosis. Atherosclerotic renal artery stenosis (ARAS) and fibromuscular dysplasia are the two most prevalent causes of RVH. The ultimate objective of controlling RVH, like with other kinds of hypertension, is to minimize the morbidity and mortality associated with high blood pressure The widespread use of effective antihypertensive medication treatment, statins, and other strategies to control vascular disease has resulted in remarkable improvements. In this review we will be looking at etiology, pathogenesis and treatment or RVH.

Clinical Innovation: A Multidisciplinary Program for the Diagnosis and Treatment of Systemic Hypertension in Children and Adolescents

2020 ◽  
Vol 59 (3) ◽  
pp. 228-235 ◽  
Author(s):  
Michelle Kaplinski ◽  
Heather Griffis ◽  
Fang Liu ◽  
Craig Tinker ◽  
Nina C. Laney ◽  
...  
Keyword(s):  
Blood Pressure ◽  
At Risk ◽  
Ambulatory Blood Pressure Monitoring ◽  
Ambulatory Blood Pressure ◽  
Antihypertensive Medication ◽  
Blood Pressure Monitoring ◽  
Systemic Hypertension ◽  
Clinic Blood Pressure ◽  
Pressure Monitoring ◽  
Multidisciplinary Program

Pediatric systemic hypertension (HTN) is underdiagnosed and undertreated. The Divisions of Cardiology and Nephrology at our institution developed a comprehensive outpatient HTN program to (1) screen children at risk for HTN, (2) assess cardiovascular health, and (3) optimize medical management. We report our findings during all initial visits (n = 304) from December 2011 to September 2018. Of the cohort, 38% were obese and 36% reported little to no exercise. More than half of patients ≥11 years old did not have recommended lipid screening. When evaluating ambulatory blood pressure monitoring results, clinic blood pressure did not accurately diagnose patients with or without HTN and many patients on antihypertensive medications were inadequately treated. Visit recommendations included addition of or changes to antihypertensive medication in 35% of patients. A multidisciplinary program dedicated to pediatric HTN helps screen patients who are at risk. Ambulatory blood pressure monitoring identifies HTN in patients with normal clinic blood pressure and those on antihypertensive medication.

scholarly journals Case report: secondary hypertension in a 6-year old child with bilateral renal artery stenosis

2020 ◽  
Vol 1 (2) ◽  
pp. 45-50
Author(s):  
Tatyana A. Ryazanova ◽  
Yuliya A. Trunova ◽  
Anastasia S. Arkhipova
Keyword(s):  
Case Report ◽  
Renal Artery ◽  
Renal Artery Stenosis ◽  
Renovascular Hypertension ◽  
Fibromuscular Dysplasia ◽  
Clinical Symptoms ◽  
Secondary Hypertension ◽  
Renal Arteries ◽  
Artery Stenosis ◽  
Bilateral Renal Artery Stenosis

Background. Renovascular hypertension (RVH) is an elevated blood pressure caused by partial or complete occlusion of one or both renal arteries or their branches. According to different studies, renal artery stenosis accounts for 5–10% of all cases of hypertension in children. The most common causes of renal artery stenosis are deemed to be atherosclerosis and fibromuscular dysplasia.Case description. The article describes clinical case of a newly diagnosed renovascular hypertension amid background of fibromuscular dysplasia of renal arteries in a 6-year old child, particulars of the clinical course, laboratory and instrumental methods of investigation and treatment including aortography and balloon angioplasty of renal arteries.Conclusion. This case report illustrates that in the absence of complaints and pronounced clinical symptoms the diagnosis of renovascular hypertension in a 6-year old child could not be established for a long time. Timely detection of elevated BP in children, including the young ones, not only during visiting specialist physicians but also during prophylactic examination by pediatrician, is required for early diagnosis of the disease and development of the examination and treatment strategy.

scholarly journals Case report: secondary hypertension in a 6-year old child with bilateral renal artery stenosis

2020 ◽  
Vol 1 (2) ◽  
pp. 45-50
Author(s):  
Tatyana A. Ryazanova ◽  
Yuliya A. Trunova ◽  
Anastasia S. Arkhipova
Keyword(s):  
Case Report ◽  
Renal Artery ◽  
Renal Artery Stenosis ◽  
Renovascular Hypertension ◽  
Fibromuscular Dysplasia ◽  
Clinical Symptoms ◽  
Secondary Hypertension ◽  
Renal Arteries ◽  
Artery Stenosis ◽  
Bilateral Renal Artery Stenosis

Background. Renovascular hypertension (RVH) is an elevated blood pressure caused by partial or complete occlusion of one or both renal arteries or their branches. According to different studies, renal artery stenosis accounts for 5–10% of all cases of hypertension in children. The most common causes of renal artery stenosis are deemed to be atherosclerosis and fibromuscular dysplasia.Case description. The article describes clinical case of a newly diagnosed renovascular hypertension amid background of fibromuscular dysplasia of renal arteries in a 6-year old child, particulars of the clinical course, laboratory and instrumental methods of investigation and treatment including aortography and balloon angioplasty of renal arteries.Conclusion. This case report illustrates that in the absence of complaints and pronounced clinical symptoms the diagnosis of renovascular hypertension in a 6-year old child could not be established for a long time. Timely detection of elevated BP in children, including the young ones, not only during visiting specialist physicians but also during prophylactic examination by pediatrician, is required for early diagnosis of the disease and development of the examination and treatment strategy.

Renovascular Hypertension: Comparison of Medical and Surgical Therapy

1979 ◽  
Vol 57 (s5) ◽  
pp. 445s-447s ◽  
Author(s):  
P. K. Whelton ◽  
A. P. Harris ◽  
R. P. Russell ◽  
P. C. Walsh ◽  
G. M. Williams ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Renal Function ◽  
Diastolic Blood Pressure ◽  
Renovascular Hypertension ◽  
Surgical Therapy ◽  
Antihypertensive Medication ◽  
Renovascular Disease ◽  
Significant Difference ◽  
Blood Pressures

1. Results of medical and surgical therapy were compared in 28 patients with hypertension and unilateral renovascular ischaemia. 2. Renal function remained normal in both groups throughout the study period. After 6 months of follow-up systolic and diastolic blood pressures were significantly lower in the surgically treated patients. After 12 months of follow-up there was no significant difference between the two groups in diastolic blood pressure and after 24 months of follow-up there was no significant difference between the two groups in either systolic or diastolic blood pressure. 3. Sixty per cent of surgically treated patients were cured 6 months after operation, but only 40% remained cured after 24 months of follow-up. 4. All patients cured at 6 months who subsequently required antihypertensive medication had arteriosclerotic renovascular disease.

scholarly journals Renovascular hypertension in children

2021 ◽  
Vol 4 (1) ◽  
Author(s):  
Premal Amrishkumar Patel ◽  
Anne Marie Cahill
Keyword(s):  
Blood Pressure ◽  
Renal Artery ◽  
Renovascular Hypertension ◽  
Gold Standard ◽  
Fibromuscular Dysplasia ◽  
Neurofibromatosis Type ◽  
Renovascular Disease ◽  
Surgical Options ◽  
Hypertension In Children

AbstractPaediatric hypertension, defined as systolic blood pressure > 95th percentile for age, sex and height is often incidentally diagnosed. Renovascular hypertension (RVH) is responsible for 5–25% of hypertension in children. Renal artery stenosis and middle aortic syndrome can both can be associated with various conditions such as fibromuscular dysplasia, Williams syndrome & Neurofibromatosis type 1. This paper discusses the approaches to diagnosis and interventional management and outcomes of renovascular hypertension in children. Angiography is considered the gold standard in establishing the diagnosis of renovascular disease in children. Angioplasty is beneficial in the majority of patients and generally repeated angioplasty is considered more appropriate than stenting. Surgical options should first be considered before placing a stent unless there is an emergent requirement. Given the established safety and success of endovascular intervention, at most institutions it remains the preferred treatment option.

scholarly journals Case report: secondary hypertension in a 6-year old child with bilateral renal artery stenosis

2020 ◽  
Vol 1 (2) ◽  
pp. 45-50
Author(s):  
Tatyana A. Ryazanova ◽  
Yuliya A. Trunova ◽  
Anastasia S. Arkhipova
Keyword(s):  
Case Report ◽  
Renal Artery ◽  
Renal Artery Stenosis ◽  
Renovascular Hypertension ◽  
Fibromuscular Dysplasia ◽  
Clinical Symptoms ◽  
Secondary Hypertension ◽  
Renal Arteries ◽  
Artery Stenosis ◽  
Bilateral Renal Artery Stenosis

Background. Renovascular hypertension (RVH) is an elevated blood pressure caused by partial or complete occlusion of one or both renal arteries or their branches. According to different studies, renal artery stenosis accounts for 5–10% of all cases of hypertension in children. The most common causes of renal artery stenosis are deemed to be atherosclerosis and fibromuscular dysplasia.Case description. The article describes clinical case of a newly diagnosed renovascular hypertension amid background of fibromuscular dysplasia of renal arteries in a 6-year old child, particulars of the clinical course, laboratory and instrumental methods of investigation and treatment including aortography and balloon angioplasty of renal arteries.Conclusion. This case report illustrates that in the absence of complaints and pronounced clinical symptoms the diagnosis of renovascular hypertension in a 6-year old child could not be established for a long time. Timely detection of elevated BP in children, including the young ones, not only during visiting specialist physicians but also during prophylactic examination by pediatrician, is required for early diagnosis of the disease and development of the examination and treatment strategy.

Blood pressure, antihypertensive medication, and atherosclerotic renal artery stenosis

1999 ◽  
Vol 33 (4) ◽  
pp. 675-681 ◽  
Author(s):  
Michael J. Tullis ◽  
Michael T. Caps ◽  
R.Eugene Zierler ◽  
Robert O. Bergelin ◽  
Nayak Polissar ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Renal Artery ◽  
Renal Artery Stenosis ◽  
Antihypertensive Medication ◽  
Artery Stenosis ◽  
Atherosclerotic Renal Artery Stenosis

Percutaneous Transluminal Dilatation of Renal Artery Stenosis: 2 years' Experience

1981 ◽  
Vol 61 (s7) ◽  
pp. 481s-483s ◽  
Author(s):  
U. Kuhlmann ◽  
W. Vetter ◽  
A. Grüntzig ◽  
E. Schneider ◽  
G. Pouliadis ◽  
...  
Keyword(s):  
Renal Artery ◽  
Renal Artery Stenosis ◽  
Renovascular Hypertension ◽  
Fibromuscular Dysplasia ◽  
Artery Stenosis ◽  
Atherosclerotic Renal Artery Stenosis ◽  
Atherosclerotic Stenosis ◽  
Percutaneous Transluminal ◽  
Percutaneous Transluminal Dilatation

1. Percutaneous transluminal dilatation was performed in 37 patients with renovascular hypertension: 24 had atherosclerotic renal artery stenosis and 13 had fibromuscular dysplasia. 2. Percutaneous transluminal dilatation could not be performed for technical reasons in three (8%) of the 37 patients. 3. In the remaining 34 patients blood pressure fell significantly (P < 0.001) from 201 ± 31/118 ± 14 mmHg to 144 ± 22/91 ± 11 mmHg 3 days after the procedure. The respective values at months 6 and 24 were 148 ± 26/89 ± 12 mmHg (n = 23, P < 0.001) and 143 ± 14/89 ± 6 mmHg (n = 8, P < 0.001). 4. Certain differences between the two subgroups emerged in the response to percutaneous transluminal dilatation (6 months values, n = 23): cure rate was higher in patients with fibromuscular dysplasia than in those with atherosclerotic stenosis (67% vs 35%) and in contrast to atherosclerotic stenosis none of the cases with fibromuscular dysplasia was unimproved. 5. Follow-up angiography performed at month 6 showed recurrence of slight renal artery stenosis in five out of 19 patients (all atherosclerotic). 6. Complications were seen in six (16%) of the 37 patients. 7. Our results show that percutaneous transluminal dilatation is a valid method for the treatment of renovascular hypertension. Patients with fibromuscular dysplasia may show a better response than those with atherosclerotic stenosis. In this study the latter was complicated by a high risk of developing restenosis. Finally a complication rate of 16% requires careful selection of patients.

scholarly journals Rare Cause of Cephalalgia in a Young Woman - a Case Report

2015 ◽  
Vol 61 (4) ◽  
pp. 382-386
Author(s):  
Varga Andreea ◽  
Szakacs Xantus Timea ◽  
Gliga Mirela ◽  
Podoleanu Cristian Gheorghe Calin ◽  
Bocicor Andreea Elena ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Renal Artery ◽  
Young Woman ◽  
Fibromuscular Dysplasia ◽  
Clinical History ◽  
Abrupt Onset ◽  
Secondary Hypertension ◽  
White Coat Hypertension ◽  
Renal Ultrasound ◽  
Common Symptom

AbstractBackground: Young adults meeting hypertension diagnostic criteria have a lower prevalence of a hypertension diagnosis. Headache is a rather common symptom among young people. Fibromuscular dysplasia (FMD) is an idiopathic, segmental, nonatherosclerotic and noninflammatory disease of the muscular tunica of arterial walls, leading to stenosis of small and medium-sized arteries. Fibromuscular dysplasia is much more common than previously thought and is a treatable cause of secondary hypertension.Case presentation: We present the case of an 18 y.o. young woman, with headache and high blood pressure. “White coat hypertension” was suspected. Clinical history with abrupt onset and increasingly difficult to treat hypertension especially in women, were suggestive for renal artery stenosis. Renal ultrasound and digital subtraction angiography confirmed the aspect of FMD. Sequential percutaneous renal artery angioplasty was later performed with improved evolution both from the clinical point of view and controlled blood pressure below 140/90 mmHg with minimal antihypertensive regimen. Angio CT exam of neck and brain arteries was performed, no other FMD typical lesions were identified.Conclusions: Medical treatment is first indicated for the hypertensive patient. In this particular case percutaneous renal artery angioplasty showed significant improvement in reduction of antihypertensive treatment in a young patient with secondary hypertension. Further monitoring and management of this patient will include blood pressure measurements at 3-month intervals and renal function measurements annual, as well as non-invasive duplex ultrasonography at 12-month intervals, follow-up is indefinite. It remains challenging whether the patient can be medically managed on antihypertensive medication alone.

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