Open AccessFibromuscular Dysplasia: An Uncommon Cause of Secondary Hypertension
Author(s) -
Prisant L. Michael,
Szerlip Harold M.,
Mulloy Laura L.
Publication year - 2006
Publication title -
the journal of clinical hypertension
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.909
H-Index - 67
eISSN - 1751-7176
pISSN - 1524-6175
DOI - 10.1111/j.1524-6175.2006.06021.x
Subject(s) - fibromuscular dysplasia , medicine , renal artery stenosis , cardiology , renovascular hypertension , renal artery , secondary hypertension , angioplasty , stenosis , restenosis , angiography , radiology , blood pressure , renal artery obstruction , kidney , stent
Fibromuscular dysplasia is a noninflammatory vascular disease that commonly affects the distal two thirds of the renal artery and branch vessels, but occasionally involves other arteries. Progression of stenosis occurs in 16%–38% of renal arteries. Although the etiology is unknown, genetic studies suggest a relationship to the angiotensin‐converting enzyme I allele. Thin, young Caucasian women without a family history of hypertension are most commonly affected. An abdominal or flank systolic‐diastolic bruit is an important clue for the diagnosis. Most noninvasive screening tests are not sensitive or reproducible to be used to rule out renal artery stenosis, but digital subtraction renal angiography usually confirms the diagnosis. Percutaneous renal artery angioplasty is the treatment of choice, but may not result in normalization of blood pressure if diagnosis is delayed. Since restenosis occurs, continued follow‐up is necessary.