Normal Arterial Pressure in Patients With Renal Arterial Stenosis

Harriet P. Dustan, MD; Alfred W. Humphries, MD; Victor G. de Wolfe, MD; Irvine H. Page, MD

[+] Author Affiliations

Cleveland

From the Research Division, departments of vascular surgery and peripheral vascular disease, Cleveland Clinic Foundation.

JAMA. 1964;187(13):1028-1029. doi:10.1001/jama.1964.03060260056020

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ABSTRACT

ABSTRACT | REFERENCES

EARLY CLINICAL EXPERIENCE with renal arterial stenosis^1,2 suggested that the accompanying hypertension was severe and often of the malignant variety. Later, it became apparent that such lesions could be associated with extremely fluctuant arterial pressure levels^3,4 and that occasionally hypertension disappeared.⁵ Sutton and associates,⁶ and, more recently, Eyler and co-workers⁷ have reported finding severe renal arterial stenosis in normotensive patients who were investigated because of peripheral vascular disease.

This report describes a study of hypertension and renal arterial stenosis in a group of patients in whom renal arteriograms were obtained incidentally in the course of translumbar aortography for peripheral vascular disease. About 40% were found to have stenosis of one or both main renal arteries, but one half of these were normotensive.

Plan of Study A review of translumbar aortograms, performed for diagnosis of aorto-iliac occlusive arterial disease since 1953, yielded 149 renal arteriograms of

REFERENCES

ABSTRACT | REFERENCES

Howard, J.E., et al: Hypertension Resulting From Unilateral Renal Vascular Disease and Its Relief by Nephrectomy , Bull Hopkins Hosp 94:51-85 ( (Feb) ) 1954;.

Poutasse, E.F., and Dustan, H.P.: Arteriosclerosis and Renal Hypertension: Indications for Aortography in Hypertensive Patients and Results of Surgical Treatment of Obstructive Lesions of Renal Artery , JAMA 165:1521-1525 ( (Nov 23) ) 1957;.

Page, I.H.; Dustan, H.P.; Poutasse, E.F.: Mechanisms, Diagnosis and Treatment of Hyptertension of Renal Vascular Origin , Ann Intern Med 51:196-211 ( (Aug) ) 1959;.

Morris, G.C., Jr., et al: Surgical Treatment of Renal Hypertension , Ann Surg 151:854-866 ( (June) ) 1960;.

Wilson, L.L., et al: Diagnosis of Renal Arterial Lesions , Arch Intern Med (Chicago) 112:270-277 ( (Aug) ) 1963;.

Sutton, D.; Brunton, F.J.; and Starer, F.: Renal Artery Stenosis , Clin Radiol 12:80-90 ( (April) ) 1961;.

Eyler, W.R., et al: Angiography of Renal Areas Including Comparative Study of Renal Arterial Stenosis in Patients With and Without Hypertension , Radiology 78: 879-892 ( (June) ) 1962;.

Masters, A.M.; Dublin, L.E.; and Marks, H.H.: Normal Blood Pressure Range and Its Clinical Implications , JAMA 143:1464-1470 ( (Aug 26) ) 1950;.

Faris, A.A., et al: Radiologic Visualization of Neck Vessels in Healthy Men , Neurology (Minneap) 13:386-396 ( (May) ) 1963;.

Skinner, S.L.; McCubbin, J.W.; Page, I.H.: Renal Baroceptor Control of Renin Secretion , Science 141:814-816 ( (Aug 30) ) 1963;.

McCubbin, J.W.; Green, J.H.; and Page, I.H.: Baroceptor Function in Chronic Renal Hypertension , Circ Res 4:205-210 ( (March) ) 1956;.

McCubbin, J.W., and Page, I.H.: Renal Pressor System and Neurogenic Control of Arterial Pressure , Circ Res 12:553-561 ( (May) ) 1963;.

Laragh, J.H., et al: Hypotensive Agents and Pressor Substances: Effect of Epinephrine, Norepinephrine, Angiotensin II, and Others on Secretory Rate of Aldosterone in Man , JAMA 174:234-240 ( (Sept 17) ) 1960;.

Genest, J., et al: " Adrenocortical Function in Essential Hypertension ," in International Symposium , K. D. Bock, and P. T. Cottier, ed., Berlin: Springer-Verlag, 1960;, p. 126.

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