Premium
Hypertension and renal artery stenosis: Serial observations on 54 patients treated medically
Author(s) -
Sheps Sheldon G.,
Osmundson Philip J.,
Hunt James C.,
Schirger Alexander,
Fairbairn John F.
Publication year - 1965
Publication title -
clinical pharmacology and therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.941
H-Index - 188
eISSN - 1532-6535
pISSN - 0009-9236
DOI - 10.1002/cpt196566700
Subject(s) - medicine , renovascular hypertension , renal artery , renal artery stenosis , nephrectomy , renal artery obstruction , cardiology , stenosis , fundus (uterus) , renal function , fibromuscular dysplasia , disease , secondary hypertension , surgery , kidney , blood pressure
Medical treatment of hypertension was undertaken in 54 selected patients with arteriographically proved stenosis of the renal artery (32 with atheromatous and 22 with fibromuscular lesions). At follow‐up study (average, 20.3 months), 65 per cent of 49 surviving patients were normotensive on a regimen of common antihypertensive drugs in usual doses. There also was improvement in the hypertensive changes noted in the optic fundus. In 13 patients, additional cardiovascular episodes complicated the hypertensive disease and 5 of these patients had died. The frequent long duration of hypertension and frequent bilateral involvement of the renal arteries necessitate caution in recommending surgical treatment when: (1) the situation technically demands nephrectomy; (2) there are renovascular lesions in the absence of significant hypertension; (3) arteriographic and renal function data are discordant; and (4) there is associated severe symptomatic cardiovascular disease, old age, or other infirmities.