April 17, 1972

Work-Up for Hypertension

Author Affiliations


JAMA. 1972;220(3):420. doi:10.1001/jama.1972.03200030078035

To the Editor.—  Talso's (219:1224, 1972) answer to the question of how to evaluate a patient with elevated blood pressure is somewhat misleading. The sequence of elaborate studies for detection of possible renovascular hypertension should be reversed. Split renal-function determinations and assay of renal-vein plasma renin levels are not considered screening tests. They are only indicated and meaningful if on a preceding renal arteriogram a vascular lesion was found whose significance may be elucidated by these tests.Talso advises that split renal-function studies be done and renal venous plasma renin activity be measured. I do not know of any evidence that the combination of both of these painstaking tests adds anything. Their value seems to be equal.1