What Is Renovascular Hypertension?
Renovascular hypertension has higher blood pressure levels, and the kidneys contribute to this increase. It happens due to the narrowing of the arteries carrying the blood to the kidneys. The other name for renovascular hypertension is renal artery stenosis. There are various causes and risk factors associated with renovascular hypertension. There are several treatment options. Surgical methods are known to be highly beneficial. The patient should be educated about their condition to take better care of their health.
What Is the Epidemiology of Renovascular Hypertension?
Renovascular hypertension is known to be the second most common condition occurring in the United States of America. Older people are more commonly affected than younger people. In some patients, renovascular hypertension can occur at the age of 30, while in others, it can affect patients who are more than 50 years of age.
What Are the Causes of Renovascular Hypertension?
The main cause of renovascular hypertension is higher levels of cholesterol. The risk is increased when a fatty substance is known to thicken the inner lining of the arteries. This fatty substance is known as plaque, which is atherosclerosis. The narrowing of the arteries results in reduced blood flow compared to normal. In response to this, the kidneys release hormones that lead to increased salt and water retention. As a result, blood pressure increases. A few conditions are known to cause renovascular hypertension.
They are:
-
Acute arterial thrombosis or embolism.
-
Cholesterol embolic disease.
-
Renal arterial trauma.
-
Arterial aneurysm.
-
Arteriovenous malformation of the renal artery.
How Are the Kidneys Harmed by High Blood Pressure?
The kidneys' blood arteries, particularly the filtering units in charge of filtering the blood, are under more stress when the blood pressure is raised. Like other body regions, these arteries may harden over time, and the filtering units might develop scars. These two alterations have the potential to cause chronic renal disease, which is characterized by the kidneys' inability to function normally and eliminate waste products and excess fluid from the body. Ineffective kidneys can lead to additional spikes in blood pressure by releasing specific hormones. One of the main reasons for kidney failure is elevated blood pressure.
Does Renovascular Hypertension Affect Children?
In children, renovascular hypertension can occur both in congenital and acquired forms. The acquired type of renovascular hypertension is known to be more common than the congenital type. The occurrence of this health condition might vary in different geographical regions. The acquired type of renovascular hypertension can show the following conditions.
They are:
-
Moyamoya disease.
-
Subisthmic coarctation.
-
Takayasu arteritis.
-
Vasculitis.
-
Renal artery thrombosis.
-
Vascular trauma.
-
Anastomotic stenosis.
-
Midaortic syndrome.
-
Tumors.
What Are the Signs and Symptoms of Renovascular Hypertension?
The condition of renovascular hypertension will show the following signs:
-
Rapid buildup of fluid in the lungs will result in pulmonary edema.
-
Narrowing of the arteries in the legs, eyes, and brain.
-
Improper functioning of the kidneys.
-
Increased blood pressure in younger patients.
-
Uncontrolled levels of blood pressure even after the intake of medications.
What Are the Complications of Renovascular Hypertension?
The complications associated with renovascular hypertension are:
-
Chronic kidney disease.
-
Headache.
-
Poor blood supply to the legs.
-
Aortic aneurysm.
-
Heart failure.
-
Confusion.
-
Blurred vision.
-
Bleeding of the nose.
-
Nausea and vomiting.
-
Heart attack.
-
Stroke.
What Are the Risk Factors of Renovascular Hypertension?
The risk factors associated with renovascular hypertension are:
-
Smoking.
-
High blood pressure.
-
Increase in age.
-
Higher levels of cholesterol.
-
Diabetes.
-
Cocaine abuse.
-
Consumption of heavy alcohol.
What Are the Diagnostic Procedures for Renovascular Hypertension?
In the initial stages, diagnosis is made using ultrasonography and magnetic resonance angiography. In some patients, procedures like radionuclide imaging are used. Renal angiography is a highly beneficial test that can also be used for therapeutic procedures. It would require a few other tests, such as radionuclide imaging, magnetic resonance angiography, and ultrasonography, to identify whether the patient is eligible for the renal angiography test.
Duplex Doppler ultrasonography is also a useful diagnostic test that can identify kidney blood flow. It is a non-invasive procedure, and it is usually reliable. Stenosis in the renal arteries can be identified with this method. It is a technique-sensitive procedure and would require qualified technicians to perform the test.
Radionuclide imaging is a diagnostic procedure that is done before and after the administration of drugs like Captopril. It is an angiotensin-converting enzyme inhibitor (ACE inhibitor). It will help in treating the narrow, affected artery.
Digital subtraction angiography is a diagnostic procedure in which the renal arteries are selectively injected to confirm a diagnosis.
What Are the Treatment Options for Renovascular Hypertension?
The treatment requires certain lifestyle modifications and medications. The patient should be aware of their cholesterol levels, as they can increase the risk of other conditions.
-
Lifestyle Changes: A healthy heart is a way to cure renovascular hypertension. A balanced and fat-free diet will be required for faster recovery. It is essential to exercise for a minimum of 30 minutes per day. If individuals are smokers, then they should quit the habit of smoking. Alcohol must be completely avoided. It is necessary to reduce the sodium intake in the diet. The ideal sodium level should be maintained at less than 1500 mg per day. It is necessary to check with the doctor regarding the potassium levels. Stress is an important contributor to weight gain. The levels of stress can be reduced by practicing yoga and meditation techniques.
-
Medical Treatment: The doctor will record a thorough history of the patient. After considering all the past medical history and other associated diseases, the patient will be prescribed medications to treat atherosclerosis, hypertension, and renal disorders. The treatment is always aimed at improving the condition of the kidney. If the kidney cannot be vascularized again, the patient is recommended for a nephrectomy.
-
Angioplasty: Angioplasty is performed for patients with fibromuscular dysplasia. It is a low-risk procedure that can improve blood pressure control. Balloon angioplasty is the treatment suggested for obstructions in the renal artery. This is done with or without the placement of a stent, which will reduce the risk of reoccurrence of stenosis.
What Are the Precautionary Measures?
-
If individuals have increased blood sugar levels or positive signs of diabetes, they should try to cure it first.
-
Try to keep a check on the cholesterol levels regularly.
-
Quit smoking, alcohol, and drug usage.
How Is the Prognosis?
If the blood pressure is relatively higher, the prognosis is very poor. Proper control of hypertension will help the patient escape complications and retain a long life.
Is Renal Hypertension Treated With Surgery?
Renal bypass surgery may be a possibility if the illness fails to get better with medicine and angioplasty, if the constriction reappears, or if stenting is not possible for any reason. The surgeon constructs a bypass, or another path, for blood to flow around the clogged artery and into the kidneys by using a blood vessel or artificial tube that links the kidney to the aorta. This is an extremely uncommon, potentially dangerous, and intricate treatment.
Conclusion:
Renovascular hypertension results from a disruption in the blood supply to the kidneys, which triggers a hormone reaction in the afflicted kidney, raising blood pressure. This is a dangerous illness that can result in fatalities as well as complications, including heart attacks and strokes. Determine the best course of action with a medical practitioner, take all prescribed drugs, and adhere to all post-operative instructions to the fullest.
