Hypertension and Renal Arterial Disease

Renovascular hypertension has been known for almost 80 years, since seminal experimental research showed that gradual obstruction of the renal arteries causes a rise in systemic arterial pressure. These findings established the kidney as a key regulator of blood pressure and provided one of the most well researched models of "angiotensin-dependent" hypertension . Although progressive decline in renal blood flow eventually leads to other disruptions, including impaired volume management, circulatory congestion, and eventually irreversible kidney injury, this can occur at levels of renal pressure above those that impair kidney function. As a result, occlusive renovascular disease (RVD) encompasses a wide range of diseases, from small to major. In Western countries, atherosclerotic renal artery stenosis is the most common cause of RVD (at least 85 percent) (ARAS). This is usually the result of systemic atherosclerosis, which affects several arterial beds, including the coronary, cerebral, and peripheral vessels.

Author(s): Tim David

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