Diagnostic Evaluation for Patients With Renovascular Hypertension

The overall prevalence of renovascular hypertension is low, accounting for only 5% of all hypertensive patients in the general population and between 10 and 45% of those in a hypertension subspecialty practice (1,2) . Thus, routine screening is neither cost effective nor efficient; screening should be performed only on those patients with historical and physical findings, which raise suspicion for renovascular disease. Additionally, renal artery stenosis in not synonymous with renovascular hypertension, as illustrated by multiple autopsy series (3–5) . In a series of 154 randomly selected autopsies, Schwartz and White showed a strong association between renal artery stenosis and advancing age but no correlation between stenosis and increased diastolic blood pressure (DBP) (4) . Similarly, Holley and coworkers (3) found that 49% of normotensive and 77% of hypertensive patients have evidence of moderate to severe renal artery stenosis. These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.