Renovascular disease is an independent risk factor for left ventricular hypertrophy, perhaps reflecting the adverse effects of chronic activation of the rennin-angiotensin system.
Renovascular disease is the most frequent correctable cause of secondary hypertension, its prevalence varies according to the clinical circumstances, being relatively uncommon in patents with mild hypertension but quite common (incidence 20% to 45%) in patients with severe or refractory hypertension.
Several recognized clinical situations that show the presence of renovascular disease are:
*Accelerated hypertension at any age
*Episodes of flash pulmonary edema with normal ventricular function
*Acute unexplained rise in serum creatinine after an angiotensin-converting enzyme inhibitor
*Elevated serum creatinine in patients with severe or refractory hypertension
*Asymmetrical renal size
*Moderate to severe hypertension in a patient with diffuse atherosclerotic disease
Two clinical subgroups comprise the majority of patients with renovascular hypertension: fibromuscular dysplasia and atherosclerotic disease. Fibromuscular dysplasia of the renal arteries accounts less than 10% of all renovascular hypertension and occurs mainly in younger women.
Renovascular disease
