Renovascular hypertension is high blood pressure due to narrowing of the arteries that carry blood to the kidneys.
When the arteries that carry blood to your kidneys become narrow, less blood flows to the kidneys. The kidneys mistakenly respond as if your blood pressure is low and give off hormones that tell the body to hold on to more salt and water. This causes your blood pressure to rise.
Renal artery stenosis is a narrowing or blockage of the artery that supplies blood to the kidneys.
The most common cause of renal artery stenosis is hardening of the arteries (atherosclerosis) from high cholesterol.
Fibromuscular dysplasia is another cause of renal artery stenosis, particularly in women under age 50. It tends to run in families. Fibromuscular dysplasia is caused by abnormal growth or development of cells in the walls of the arteries leading to the kidneys. This also leads to narrowing or blockage of these arteries.
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.
People with renovascular hypertension usually have severe, difficult-to-control high blood pressure. They may have a history of high blood pressure that is hard to control or does not get better with medication.
Your doctor may hear a "whooshing" noise, called a bruit, when placing a stethoscope over your belly area.
Other signs of this disease include:
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 to see if the kidney arteries have narrowed. They include:
High blood pressure caused by narrowing of the arteries that lead to the kidneys (renovascular hypertension) is often difficult to control.
Medications may be used to help control blood pressure. There are a variety of high blood pressure medications available. You and your doctor will decide which type is best for you.
Have your cholesterol checked and treated. If you have diabetes, heart disease, or hardening of the arteries somewhere else in your body, your "bad" (LDL) cholesterol should be lower than 100 mg/dL.
To help prevent hardening of the arteries, make the following lifestyle changes:
Further treatment depends on what causes the narrowing of the kidney arteries. For example, your doctor may recommend a procedure called angioplasty with stenting if you have this condition and it is not well-managed with medications. For information, see: Stent.
Call for an appointment with your health care provider if you think you have high blood pressure.
Call your health care provider if you have renovascular hypertension and symptoms get worse or do not improve with treatment. Also call if new symptoms develop.
Preventing atherosclerosis may prevent the development of rental artery stenosis.
Lifestyle changes may reduce your risk of high blood pressure. Lose weight if you are overweight. Excess weight makes the heart work harder. Check with your doctor before starting a rigorous exercise program.
Changes in your diet may help to control your blood pressure. Reduce the amount of salt (sodium) you use. Salt, MSG, and baking soda all contain sodium.
See also: Heart disease and diet
Renal hypertension; Hypertension - renovascular; Renal artery occlusion; Stenosis - renal artery