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Article
June 1974

Renal and Renovascular Hypertension: A Reasoned Approach to Diagnosis and Management

Arch Intern Med. 1974;133(6):988-999. doi:10.1001/archinte.1974.00320180106009
Abstract

Hypertension occurs in 10% to 15% of adults. Hypertension may hasten atherosclerosis and is considered an important predisposing factor to coronary artery disease.

Our prospective investigations suggest that 10% to 15% of hypertension in adults has a cardiovascular or renal cause, such as abdominal aortic aneurysm, renal artery stenosis, renal infarction, neoplasia, glomerulopathy, or infection.

Renal artery stenosis is a common correctable cause. The functional importance of angiographically proved stenosis can be determined from renal vein renin activity, differential renal function, or a continuous abdominal bruit. Intravenous urography and isotope renography are valuable adjunctively.

In 7 to 14 years of study, mortality was 16% among surgically treated patients and 40% among similar medically treated patients.

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