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Patient education: Renovascular hypertension (The Basics)

Patient education: Renovascular hypertension (The Basics)

What is renovascular hypertension? — 

This is a type of high blood pressure. It happens when the renal arteries (the blood vessels that carry blood to the kidneys) become narrow (figure 1). Renovascular hypertension is sometimes called "renal artery stenosis."

High blood pressure puts you at risk for heart attack, stroke, and kidney disease. It does not usually cause symptoms. But it can be serious.

When your doctor or nurse tells you your blood pressure, they say 2 numbers. For instance, your doctor or nurse might say your blood pressure is "140 over 90." The top number is the pressure inside your arteries when your heart is contracting. The bottom number is the pressure inside your arteries when your heart is relaxed.

This table shows how doctors and nurses define high and normal blood pressure (table 1).

Will I need tests? — 

Maybe. If you have renovascular hypertension, your doctor might be able to hear a "whooshing" sound when listening to your belly through a stethoscope.

The doctor can also order imaging tests that create pictures of your renal arteries. But these are only done if the doctor thinks a procedure to open up your arteries could be helpful.

Should I see a doctor or nurse? — 

See your doctor or nurse right away if you have high blood pressure and get any of these symptoms:

Very bad headache

Chest pain

Severe pain in your upper back

Problems breathing

Weakness on only 1 side of your body

Problems speaking

Nausea or vomiting

Confusion

Vision changes

Blood in your urine

These can be signs of a very serious type of high blood pressure that needs to be treated as soon as possible.

How is renovascular hypertension treated? — 

Treatments include medicines for high blood pressure, such as:

ACE inhibitors and ARBs – These are often grouped together because they work in similar ways. They can help prevent kidney disease.

Some examples of ACE inhibitors include enalapril, captopril, and lisinopril.

Some examples of ARBs include candesartan (brand name: Atacand) and valsartan (brand name: Diovan).

Diuretics – Some examples include chlorthalidone, hydrochlorothiazide ("HCTZ"), and furosemide (brand name: Lasix).

Calcium channel blockers – Some examples include amlodipine (brand name: Norvasc), felodipine (brand name: Plendil), and diltiazem (brand name: Cardizem). These medicines also help prevent chest pain caused by heart disease.

Beta blockers – Some examples include atenolol (brand name: Tenormin), metoprolol (brand names: Lopressor, Toprol-XL), and propranolol (brand name: Inderal LA).

For more detailed information about these medicines, ask your doctor or nurse for the patient drug information handout from UpToDate. It explains how to use each medicine, describes its possible side effects, and lists other medicines or foods that can affect how it works.

Your doctor might recommend a procedure called "angioplasty" to open up 1 (or possibly both) of your renal arteries. During angioplasty, the doctor puts a thin tube into a blood vessel in your leg and advances the tube to your kidney. Then, they inflate a tiny balloon inside the clogged artery to reopen it. They often prop open the artery using a tiny mesh tube called a "stent." Doctors only recommend angioplasty in certain situations.

Can renovascular hypertension be prevented? — 

You can reduce your chances of getting it by keeping your blood vessels healthy. To do that, you should:

Quit smoking, if you smoke. Your doctor or nurse can help.

Walk or do some kind of physical activity on most days of the week.

Lose weight, if you have excess body weight.

More on this topic

Patient education: High blood pressure in adults (The Basics)
Patient education: High blood pressure in children (The Basics)
Patient education: Medicines for high blood pressure (The Basics)
Patient education: Controlling your blood pressure through lifestyle (The Basics)
Patient education: Coronary artery disease (The Basics)
Patient education: DASH diet (The Basics)

Patient education: High blood pressure in adults (Beyond the Basics)
Patient education: High blood pressure treatment in adults (Beyond the Basics)
Patient education: High blood pressure in children (Beyond the Basics)
Patient education: High blood pressure treatment in children (Beyond the Basics)
Patient education: High blood pressure, diet, and weight (Beyond the Basics)

This topic retrieved from UpToDate on: May 11, 2025.
Disclaimer: This generalized information is a limited summary of diagnosis, treatment, and/or medication information. It is not meant to be comprehensive and should be used as a tool to help the user understand and/or assess potential diagnostic and treatment options. It does NOT include all information about conditions, treatments, medications, side effects, or risks that may apply to a specific patient. It is not intended to be medical advice or a substitute for the medical advice, diagnosis, or treatment of a health care provider based on the health care provider's examination and assessment of a patient's specific and unique circumstances. Patients must speak with a health care provider for complete information about their health, medical questions, and treatment options, including any risks or benefits regarding use of medications. This information does not endorse any treatments or medications as safe, effective, or approved for treating a specific patient. UpToDate, Inc. and its affiliates disclaim any warranty or liability relating to this information or the use thereof. The use of this information is governed by the Terms of Use, available at https://www.wolterskluwer.com/en/know/clinical-effectiveness-terms. 2025© UpToDate, Inc. and its affiliates and/or licensors. All rights reserved.
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