Until about 5 years ago, essential hypertension was a proper and acceptable diagnosis applicable to all patients with elevation in diastolic blood pressure after certain studies had excluded such surgically correctable conditions as coarctation, pheochromocytoma, and Cushing's syndrome. Renal artery stenosis, or the Goldblatt kidney type of hypertension, was considered a medical curiosity accounting for high blood pressure in less than one per cent of cases. Renewed interest in this problem, however, derived largely from certain developments in cardiovascular surgery and the more widespread application of diagnostic angiography, has led to the realization that an appreciable proportion of patients in whom the diagnosis of essential hypertension has been made actually may have renovascular occlusive disease. Indeed, at the present time it would seem that this incidence may be as high as 25% to 30% of all patients with diastolic hypertension.
Although a number of diagnostic screening tests have been developed