Renovascular Hypertension

• Heart failure.

• Heart disease.

• Stroke.

• Kidney failure.

• Blood vessel damage.

• Blindness or vision problems.

• A type of dementia caused by reduced blood flow to the brain (vascular dementia).

• Atherosclerosis. This is a hardening of the renal arteries. It causes plaque to build up and block the renal arteries.

• Fibromuscular hyperplasia. This is a condition in which cells of the artery wall overgrow, causing a narrowing of the renal arteries. It is a common cause of renovascular hypertension in younger women.

• A blockage in the renal artery due to injury, tumors, or blood clots. This is rare.

• You are a woman who is younger than age 30.

• You are a man who is older than age 50.

• You have a history of heart problems or strokes.

• Sudden high blood pressure that gets worse in older people who previously had well-controlled blood pressure.

• Nausea and vomiting.

• Vision problems.

• Chest pain.

• Flash pulmonary edema, which is sudden shortness of breath due to fluid buildup in the lungs.

• A physical exam and blood pressure check. During the exam, your health care provider may use a stethoscope to listen for a “whooshing” noise over the abdomen or on either side between the ribs and the hip.

• Blood tests to measure renin (an enzyme that helps control your blood pressure) and to check your hormone levels, including a hormone called aldosterone. Aldosterone controls the salt and water balance in your body.

• Imaging tests. These may include:

  • An ultrasound. This test uses sound waves to produce an image of the inside of your body.

  • A CT scan of your abdomen.

  • An MRI of the arteries that supply the kidneys.

  • A renal angiogram. For this test, a dye is injected into a kidney artery to show narrowing of the artery on an X-ray.

• Medicines to help you control your blood pressure.

• Treatments or lifestyle changes to address factors or conditions that may be contributing to high blood pressure. This may mean lowering your cholesterol, eating a heart-healthy diet, exercising, and maintaining a healthy body weight.

• Surgery to remove a blockage. This may be necessary if a renal artery is blocked badly.

• Percutaneous transluminal renal angioplasty (PTRA). This is a procedure to open narrow renal arteries if they are not completely blocked. Sometimes, a stent is placed in the artery to prevent the artery from becoming blocked again.

Monitoring your blood pressure

• Monitor your blood pressure at home as told by your health care provider.

  • A blood pressure reading is recorded as two numbers, such as 120 over 80 (or 120/80). The first (“top”) number is called the systolic pressure. It is a measure of the pressure in your arteries when your heart beats. The second (“bottom”) number is called the diastolic pressure. It is a measure of the pressure in your arteries as your heart relaxes between beats. A normal blood pressure reading is:

    • Systolic: below 120.

    • Diastolic: below 80.

  • Your personal target blood pressure may vary depending on your medical conditions, your age, and other factors.

• Have your blood pressure rechecked as told by your health care provider.

Lifestyle

• Work with your health care provider to maintain a healthy body weight or to lose weight. Ask what a healthy weight is for you.

• Get regular exercise. Try to do moderate exercise for at least 150 minutes each week (30 minutes on most days of the week). Moderate exercise can include walking, yoga, or gardening.

• Do not use any products that contain nicotine or tobacco, such as cigarettes, e-cigarettes, and chewing tobacco. If you need help quitting, ask your health care provider.

• Do not use street drugs.

Eating and drinking

• Eat a heart-healthy diet. This may include:

  • Following the DASH diet. This diet is high in fruits, vegetables, and whole grains. It is low in salt (sodium), saturated fat, and added sugars.

  • Keeping your sodium intake below 1,500 mg per day. Do not add salt to your food. Check food labels to see how much sodium is in a food or beverage.

• Do not drink alcohol if:

  • Your health care provider tells you not to drink.

  • You are pregnant, may be pregnant, or are planning to become pregnant.

• If you drink alcohol:

  • Limit how much you use to:

    • 0–1 drink a day for women.

    • 0–2 drinks a day for men.

  • Be aware of how much alcohol is in your drink. In the U.S., one drink equals one 12 oz bottle of beer (355 mL), one 5 oz glass of wine (148 mL), or one 1½ oz glass of hard liquor (44 mL).

• Limit caffeine. Caffeine may make your renovascular hypertension worse. Check ingredients and nutrition facts to see if a food or beverage contains caffeine.

General instructions

• Take over-the-counter and prescription medicines only as told by your health care provider.

• Keep all follow-up visits as told by your health care provider. This is important.