Renovascular hypertension - Symptom
Alternative Names
Renal hypertension; Hypertension - renovascular
Symptoms:
Usually, high blood pressure causes no symptoms. Occasionally you may have a mild headache. If your headache is severe, or if you have any of the symptoms below, see a doctor right away. These may be a sign of malignant hypertension.
- Blood in urine
- Confusion
- Crushing, angina-like chest pain
- Ear noise or buzzing
- Irregular heartbeat
- Nosebleed
- Tiredness
- Vision changes
Signs and tests:
Persons with renovascular hypertension usually have severe, difficult-to-control high blood pressure. Elevated blood pressure measurements, repeated over time, confirm hypertension.
Your doctor may hear a "whooshing" noise, or bruit, when placing a stethoscope over your belly area.
Other signs of this disease include:
- Episodes of heart failure (flash pulmonary edema)
- Rapid progression of kidney failure
- Acute kidney failure occurs when starting blood pressure medicines called ACE-I or ARBs
- Hypertension in an elderly patient whose blood pressure was previously well controlled
There may be signs of complications, such as:
Your doctor may order blood tests to check your renin and aldosterone levels. Imaging tests may be done see if the kidney arteries have narrowed. They include:
- Renal arteriography
- Doppler ultrasound of the renal arteries
- Magnetic resonance angiography (MRA)
- Angiotensin converting enzyme (ACE) inhibition renography
- Reviewed last on: 4/14/2008
- Parul Patel, MD, Private Practice specializing in Nephrology and Kidney and Pancreas Transplantation, Affiliated with California Pacific Medical Center, Department of Transplantation, San Francisco, CA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
References
White CJ. Catheter-based therapy for atherosclerotic renal artery stenosis. Circulation. 2006;113:1464-1473.
Balk E, Raman G, Chung M, Ip S, Tatsioni A, Alonso A, et al. Effectiveness of management strategies for renal artery stenosis: a systematic review. Ann Intern Med. 2006;145:901-912.
Textor SC. Renovascular hypertension update. Curr Hypertens Rep. 2006;8:521-527.
Victor RG. Arterial Hypertension. In: Goldman L, Ausiello D, eds. Cecil Textbook of Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007.
U.S. Preventive Services Task Force. Screening for high blood pressure: U.S. Preventive Services Task Force reaffirmation recommendation statement. Ann Intern Med. 2007 Dec 4;147(11):783-6.
Wolff T, Miller T. Evidence for the reaffirmation of the U.S. Preventive Services Task Force recommendation on screening for high blood pressure. Ann Intern Med. 2007 Dec 4;147(11):787-91. Review.
