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Renovascular hypertension - Symptom

Alternative Names

Renal hypertension; Hypertension - renovascular; Renal artery occlusion; Stenosis - renal artery

Symptoms:

Usually, high blood pressure causes no symptoms. Occasionally you may have a mild headache. If your headache is severe, or if you have any of the symptoms below, see a doctor right away. These may be a sign of malignant hypertension.

  • Blood in urine
  • Confusion
  • Crushing, angina-like chest pain
  • Ear noise or buzzing
  • Irregular heartbeat
  • Nosebleed
  • Tiredness
  • Vision changes

Signs and tests:

People with renovascular hypertension usually have severe, difficult-to-control high blood pressure. They may have a history of high blood pressure that is hard to control or does not get better with medication.

Your doctor may hear a "whooshing" noise, called a bruit, when placing a stethoscope over your belly area.

Other signs of this disease include:

  • Acute kidney failure occurs when starting blood pressure medicines called ACE-I or ARBs
  • Episodes of heart failure (flash pulmonary edema)
  • Hypertension in an elderly patient whose blood pressure was previously well controlled
  • Rapid progression of kidney failure

There may be signs of complications, such as:

Your doctor may order blood tests to check your renin and aldosterone levels. Imaging tests may be done to see if the kidney arteries have narrowed. They include:

  • Angiotensin converting enzyme (ACE) inhibition renography
  • Doppler ultrasound of the renal arteries
  • Magnetic resonance angiography (MRA)
  • Renal arteriography
  • Reviewed last on: 5/20/2009
  • Parul Patel, MD, Private Practice specializing in Nephrology and Kidney and Pancreas Transplantation, Affiliated with California Pacific Medical Center, Department of Transplantation, San Francisco, CA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

References

Balk E, Raman G, Chung M, Ip S, Tatsioni A, Alonso A, et al. Effectiveness of management strategies for renal artery stenosis: a systematic review. Ann Intern Med. 2006;145:901-912.

DuBose TD Jr, Santos RM. Vascular disorders of the kidney. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 126.

U.S. Preventive Services Task Force. Screening for high blood pressure: U.S. Preventive Services Task Force reaffirmation recommendation statement. Ann Intern Med. 2007;147(11):783-786.

Victor RG. Arterial hypertension. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007.

White CJ. Catheter-based therapy for atherosclerotic renal artery stenosis. Circulation. 2006;113:1464-1473.

Wolff T, Miller T. Evidence for the reaffirmation of the U.S. Preventive Services Task Force recommendation on screening for high blood pressure. Ann Intern Med. 2007;147(11):787-791.

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