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June 11, 1982

Renovascular Hypertension

JAMA. 1982;247(22):3139. doi:10.1001/jama.1982.03320470079046

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Renovascular hypertension was among the first models of hypertension to receive true scientific expression, but it has taken 50 years to arrive at some consensus as to how to treat it. Breslin, Swinton, Libertino, and Zinman have edited a book aimed at guiding the clinician. Their contributors have been well chosen. The coverage includes pathophysiology, natural history, radiology, renal angioplasty, and surgical treatment of renovascular hypertension.

It is good that the interrelatedness of the varied regulatory mechanisms controlling blood pressure and tissue perfusion comes through, although not formally stated. Thus, too much dependence in diagnosis is not placed on any single datum, such as plasma renin activity. What needs constant emphasis is that the main reason for angioplasty, or surgical correction, is maintenance of renal function. Modern treatment of hypertension, renovascular or otherwise, can be very effective. Patients resistant to some form of treatment are rare indeed, if such exist.