Renovascular Hypertension – Symptoms, Causes & Treatment - Ahmedabad

Renovascular hypertension is a form of high blood pressure caused by reduced blood flow to the kidneys. This activates a hormone system (RAAS) that causes blood vessels to constrict and retain more fluid, leading to elevated blood pressure. It is a type of secondary hypertension, meaning there is an identifiable and treatable underlying cause.

Symptoms

Renovascular hypertension often presents subtly. Key indicators include:

• High blood pressure that starts suddenly—especially in individuals under 30 or over 50

• Blood pressure that remains stubbornly high despite multiple medications

• Episodes of flash pulmonary edema (sudden fluid buildup in the lungs) or hypertensive crises

• A whooshing sound (bruit) heard over the abdomen during a physical exam

• Worsening kidney function or unexplained renal impairment in the absence of other conditions

Causes

The primary causes are:

• Renal artery stenosis—narrowing due to atherosclerosis (plaque buildup) or fibromuscular dysplasia (abnormal artery cell growth)
  Other less common contributors include vasculitis, renal artery aneurysm, tumors or fibrosis compressing renal arteries, and radiation-induced arterial damage.

Diagnosis

Healthcare providers diagnose renovascular hypertension through:

• Medical history and physical examination

• Blood and urine tests

• Imaging such as Doppler ultrasound, CT or MR angiography to assess kidney blood flow

Treatment

Management typically begins with medications:

• ACE inhibitors or ARBs are preferred as they counteract the RAAS response

• Additional drugs like diuretics, calcium channel blockers, or statins may be added if needed
  In cases unresponsive to medication:

• Angioplasty with stenting of the renal artery may be performed

• Rarely, surgical bypass may be considered in complex cases

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