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Forum Name: Miscellaneous Nephrology Topics

Question: Other causes of renovascular hypertension??


 vze3qdxk - Sun Jan 25, 2004 4:05 pm

I was recently diagnosed with renovascular hypertension based on the following:
- Age 34
- Sex: Female
- recent onset of hypertension after having a BP of 90/60 for the past 5 years
- BP diastolic consistently between 90-100
- BMI: 19
- Exercises 6 days a week
- Doesn't drink or smoke
- Creatinine: 1.1 mg/dl
- Nuclear renal scan with captopril was positive
- MRA of renal arteries showed possible blockage

However, the renal angiogram showed NO blockage. Is there something else that can be causing the hypertension or is this just another case of essential hypertension? Should additional tests be performed?

THANK YOU!
 Dr. Yasser Mokhtar - Fri Jan 30, 2004 12:08 pm

User avatar Dear vze3qdxk,

Thank you very much for using our website.

Development of hypertension in a young person especially if associated with an abdmoinal bruit usually directs the mind towards renal artery stenosis and sparks a battery of investigations to make sure that this young person does not have renovascular hypertension which is a curable form of hypertension. In your case, you went all the way to an angiogram which is the gold standard. This was normal. So, you should not carry the diagnosis of renovascular hypertension anymore.

Essential hypertension means that there is no other cause of hypertension that could be found. This means that there are other causes of hypertension, these are called secondary causes and hypertension then is called secondary hypertension. They constitute about 5% of the all the causes of hypertension.

These usually include disturbances of endocrine glands which secrete hormones. These include the thyroid gland, the adrenal glands and some rare tumours of the pituitary gland (through their effect on the thyroid gland and the adrenal glands).

These constitute only 5% of the causes of hypertension. They have clinical symptoms and signs. Your doctor most probably thought them because you are young but most probably did not think that you needed to be tested for them as you didn't have any of the symptoms or signs of those disorders otherwise he would have tested you for them.

You can always discuss these issues with your doctor and see whether he thinks if it is ok for you to be tested for those disorders or not.

If you don't have any of the secondary causes of hypertension then you have essential hypertension. Essential hypertension patients have a family history in 2/3 of the cases (you have a positive family history). It is also more common in the african american population (i am not sure whether you fit the profile) and it is associated with abdominal bruits as well (as in your case).

Once more, thank you very much for using our website http://doctorslounge.com and i hope that this information helped.

Yasser Mokhtar, M.D.
 MEem - Mon Jan 23, 2006 10:32 am


37, female, preeclampsia in the second pregnancy. Sectio cesare. No history of hypertension in the close family member. The second child was born 10 years after dhe first child. Hypertension after preeclampsia.
Metoprolol 50 mg/day (every second day) and Combined diuretica (amilorid + hydroclorothiazid) one tab every second day.
In the analysis during the pregnancy the only sing was proteinuria.
A colege doctor told me to do the hormone analysis, because it is possible that the bleeding in the hypothalamus area could be one of the reasons for the persistance of hypertension. The overweight is ocured and the profession push me to work more sedentary work. Have someone any explanation?


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