WHEN HYPERTENSION “BLOWS AWAY ” – A CASE REPORT OF RENAL ARTERY ESTENOSIS
DOI:
https://doi.org/10.58043/rphrc.91Keywords:
hypertension, renal artery stenosis, secondary hypertensionAbstract
Secondary arterial hypertension (HTN), arises as a consequence of potentially treatable conditions, has an estimated prevalence of 5-10% in the hypertensive population. Approximately 85% cases are amongst individuals aged 40 and younger. The most common secondary etiologies vary by age group, with transversal renal parenchymal disease being present in all of them. Arterial hypertension of renal origin can be the result of renovascular causes (renal artery stenosis, arteritis, or extrinsic renal artery compression) or renal parenchymal disease.
We present a case of a 26-year-old man, with history of tobacco use, diagnosed with grade 3 HTN made during occupational screening, without associated symptoms. The physical exam identified a murmur over the left lumbar region. The initial laboratorial and imaging study was negative, but the axial computed tomography angiography of the abdomen revealed the presence of significant stenosis of the left renal artery.
This case demonstrates the importance of investigating suspected secondary hypertension, even in the absence of clinical symptoms. Renal artery stenosis has treatment and its early detection can drastically change long-term prognosis.
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Williams B, Mancia G, Spiering W, Rosei EA, Azizi M, Burnier M et al; 2018 ESC/ESH Guidelines for the management of arterial hypertension - The Task Force for the management of arterial hypertension of the European Society of Cardiology (ESC) and the European Society of Hypertension (ESH); European Heart Journal 2018; 39:3021–3104
Rimoldi F, Scherrer U, Messerli FH; Secondary arterial hypertension: when, who, and how to screen? European Heart Journal 2014; 35:1245–1254
Dinis PG, Cachulo MC, Fernandes A, Paiva L, Gonçalves L; Hipertensão Arterial Sistémica Secundária: Incertezas do Diagnóstico; Acta Med Port 2017; 30(6):493-496
Courand PY, Miriana D, Lorthioir A, Bobrie G, Grataloup C, Denarié N et al; Resistant hypertension and atherosclerotic renal artery stenosis: effects of angioplasty on ambulatory blood pressure.A retrospective
uncontrolled single-center study; Hypertension 2019; 74(6):1516-1523
Manaktala R, Tafur-Soto JD, White CJ; Renal artery stenosis in the patient with hypertension: prevalence, impact and management; Integrated Blood Pressure Control 2020; 13:71-82
Gornik H, Persu A, Adlam D, Aparicio LS, Azizi M, Boulanger M et al; First International Consensus on the diagnosis and management of fibromuscular dysplasia; Vascular Medicine 2019; 24(2):164-189
Trinquart L, Mounier-Vehier C, Sapoval M, Gagnon N, Plouin PF; Efficacy of revascularization for renal artery stenosis caused by fibromuscular dysplasia – A systematic review and meta-analysis; Hypertension 2010; 56:525-532 8.ChrysantSG,ChrysantGS;Treatmentofhypertension in patients with renal artery stenosis due to fibromuscular dysplasia of the renal arteries; Cardiovasc Diagn Ther 2014; 4(1):36-43
Olin JW; Treatment of fibromuscular dysplasia of the renal arteries; In: GL Bakris, ed. UpToDate, 2022.
Textor S; Treatment of unilateral atherosclerotic renal artery stenosis; In: GL Bakris, WJ Elliott, ed. UpToDate, 2022.
Olin JW; Clinical manifestations and diagnosis of fibromuscular dysplasia; In: GL Bakris, ed. UpToDate, 2022
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Copyright (c) 2023 Carolina Midões
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