Summary about Disease
Renovascular hypertension is high blood pressure caused by narrowed or blocked arteries that supply blood to the kidneys. This narrowing, often due to atherosclerosis or fibromuscular dysplasia, reduces blood flow to the kidneys. In response, the kidneys release hormones that raise blood pressure throughout the body.
Symptoms
Many people with renovascular hypertension have no specific symptoms. When symptoms are present, they may include:
Difficult-to-control high blood pressure
High blood pressure that starts suddenly
Worsening of previously well-controlled high blood pressure
Swelling (edema)
Decreased kidney function
Abdominal bruit (an abnormal sound heard with a stethoscope over the abdomen)
Headaches
Dizziness
Vision Changes
Causes
The two main causes are:
Atherosclerosis: Hardening of the arteries due to plaque buildup. This is the most common cause, especially in older adults.
Fibromuscular Dysplasia (FMD): Abnormal cell growth in the walls of the arteries, causing narrowing. This is more common in younger women.
Medicine Used
Medications commonly used to manage renovascular hypertension include:
ACE Inhibitors and ARBs: These medications block the hormones produced by the kidneys that raise blood pressure.
Diuretics: Help remove excess fluid and sodium from the body.
Beta Blockers: Reduce heart rate and blood pressure.
Calcium Channel Blockers: Relax blood vessels.
Antiplatelet medications: such as aspirin, to prevent blood clots from forming.
Statins: to lower cholesterol levels and prevent further buildup of plaque in the arteries
Is Communicable
No, renovascular hypertension is not a communicable disease. It is not caused by an infectious agent and cannot be spread from person to person.
Precautions
Precautions and lifestyle modifications to manage renovascular hypertension include:
Healthy Diet: Low in sodium and saturated fats.
Regular Exercise: Helps lower blood pressure and improve cardiovascular health.
Weight Management: Maintaining a healthy weight reduces strain on the cardiovascular system.
Smoking Cessation: Smoking damages blood vessels.
Stress Management: Chronic stress can elevate blood pressure.
Regular Monitoring: Regular blood pressure checks and follow-up appointments with your doctor.
How long does an outbreak last?
Renovascular hypertension is not an "outbreak" situation. It is a chronic condition that, without intervention, is permanent.
How is it diagnosed?
Diagnosis involves:
Physical Exam: Including listening for an abdominal bruit.
Blood and Urine Tests: To assess kidney function.
Renal Ultrasound (Doppler): To assess blood flow to the kidneys.
Renal Artery Angiography (CTA or MRA): Imaging tests to visualize the renal arteries and identify narrowing or blockages. Angiography might involve injecting dye.
Renal Scintigraphy: A nuclear medicine test to assess kidney function and blood flow.
Timeline of Symptoms
The onset of symptoms can be gradual or sudden:
Gradual: High blood pressure develops slowly over time, often with no noticeable symptoms initially.
Sudden: High blood pressure appears abruptly, potentially with more noticeable symptoms such as severe headache, dizziness, or vision changes.
Worsening: Pre-existing hypertension becomes increasingly difficult to control with medication. The timeline and symptom severity depend heavily on the underlying cause (atherosclerosis vs. FMD), the degree of arterial narrowing, and individual factors.
Important Considerations
Renovascular hypertension can lead to serious complications if left untreated, including kidney damage, heart failure, stroke, and vision loss.
Treatment options may include medication, angioplasty and stenting, or surgery to restore blood flow to the kidneys.
Early diagnosis and treatment are crucial to preventing long-term complications.
Patients with unexplained or difficult-to-control hypertension should be evaluated for renovascular disease, especially if they have other risk factors for cardiovascular disease or a history of FMD.