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January 28, 1974, Vol 227, No. 4 >
ARTICLE | January 28, 1974

Pharmacologic Management of Renovascular Hypertension FREE

Mark R. G. Chassin, MD; Jay M. Sullivan, MD
[+] Author Affiliations

Reprint requests to Peter Bent Brigham Hospital, 721 Huntington Ave, Boston 02115 (Dr. Sullivan).


JAMA. 1974;227(4):421-423. doi:10.1001/jama.1974.03230170037011
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References

To determine the response that might be expected when renovascular hypertension is managed pharmacologically, the records of 24 patients, whose conditions were subsequently cured or improved by surgery, were examined. Mean diastolic pressure fell from 128 to 106 mm Hg, with an average of two antihypertensive agents in patients with fibromuscular hyperplasia, while an average of three agents was required to lower mean diastolic pressure, from 127 to 107 mm Hg, in patients with atherosclerotic lesions. Blood pressure elevation in fibromuscular hyperplasia is more responsive to antihypertensive agents than it is in patients with atherosclerotic lesions causing hypertension of equal severity.

REFERENCES

1 +
Laragh JH, et al:  Renin, angiotensin, and aldosterone system in pathogenesis and management of hypertensive vascular disease . Am J Med 52:633-652, 1972;.
2 +
Buhler FR, et al:  Propranolol inhibition of renin secretion . N Engl J Med 287:1209-1214, 1972;.
3 +
Brunner HR, et al:  Essential hypertension: Renin and aldosterone, heart attack and stroke . N Engl J Med 286:441-449, 1972;.
4 +
Sullivan JM, Adams DF, Hollenberg NK:  Beta-blockade in essential hypertension: Reduced renin release despite renal vasoconstriction and reduced cardiac output . Clin Res 21:453, 1973;.
5 +
Sheps SG, et al:  Hypertension and renal artery stenosis: Serial observations on 54 patients treated medically . Clin Pharmacol Ther 6:700-709, 1965;.
6 +
Kjellbo H, et al:  Renal artery stenosis: III. Follow-up observations in operated and nonoperated patients . Scand J Urol Nephrol 4:49-57, 1970;.
7 +
Dustan HP, et al:  An evaluation of treatment of hypertension associated with occlusive renal arterial disease . Circulation 27:1018-1027, 1963;.
8 +
Dustan HP, Meaney TF, Page IH:  Conservative treatment of renovascular hypertension , in Gross F (ed): Antihypertensive Therapy . Berlin, Springer-Verlag, 1966;, pp 544-554.
9 +
Buda JA, McAllister FF, Sommers SC:  Surgical treatment of renovascular hypertension . Am J Surg 119:574-578, 1970;.
10 +
Nerstrom B, Engell HC:  Operative treatment of renovascular hypertension: A study of 60 consecutive patients with follow-up findings between one and two years postoperatively . Ann Surg 176:590-596, 1972;.
11 +
Kirkendall WM, Fitz AE, Lawrence MS:  Renal hypertension: Diagnosis and surgical treatment . N Engl J Med 276:479-485, 1967;.
12 +
Luke RG, et al:  Results of surgery in hypertension due to renal artery stenosis . Br Med J 2:76-80, 1968;.
13 +
Hunter JA, Wilcox HG, Kark RM:  Problems in the treatment of renovascular hypertension . Surg Clin North Am 47:91-107, 1967;.
14 +
Hunt JC, et al:  Diagnosis and management of renovascular hypertension . Am J Cardiol 23:434-445, 1969;.
15 +
Blaufox MD, et al:  Peripheral plasma renin activity in renal-homotransplant recipients . N Engl J Med 275:1165-1168, 1966;.
16 +
Sullivan JM, Nakano KK, Tyler HR:  Plasma renin activity during levodopa therapy: Significance of long- and short-term treatment . JAMA 224:1726-1729, 1973;.
17 +
Boucher R, et al:  New procedures for measuring the human plasma angiotensin and renin activity levels . Can Med Assoc J 90:194-201, 1964;.

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1 +
Laragh JH, et al:  Renin, angiotensin, and aldosterone system in pathogenesis and management of hypertensive vascular disease . Am J Med 52:633-652, 1972;.
2 +
Buhler FR, et al:  Propranolol inhibition of renin secretion . N Engl J Med 287:1209-1214, 1972;.
3 +
Brunner HR, et al:  Essential hypertension: Renin and aldosterone, heart attack and stroke . N Engl J Med 286:441-449, 1972;.
4 +
Sullivan JM, Adams DF, Hollenberg NK:  Beta-blockade in essential hypertension: Reduced renin release despite renal vasoconstriction and reduced cardiac output . Clin Res 21:453, 1973;.
5 +
Sheps SG, et al:  Hypertension and renal artery stenosis: Serial observations on 54 patients treated medically . Clin Pharmacol Ther 6:700-709, 1965;.
6 +
Kjellbo H, et al:  Renal artery stenosis: III. Follow-up observations in operated and nonoperated patients . Scand J Urol Nephrol 4:49-57, 1970;.
7 +
Dustan HP, et al:  An evaluation of treatment of hypertension associated with occlusive renal arterial disease . Circulation 27:1018-1027, 1963;.
8 +
Dustan HP, Meaney TF, Page IH:  Conservative treatment of renovascular hypertension , in Gross F (ed): Antihypertensive Therapy . Berlin, Springer-Verlag, 1966;, pp 544-554.
9 +
Buda JA, McAllister FF, Sommers SC:  Surgical treatment of renovascular hypertension . Am J Surg 119:574-578, 1970;.
10 +
Nerstrom B, Engell HC:  Operative treatment of renovascular hypertension: A study of 60 consecutive patients with follow-up findings between one and two years postoperatively . Ann Surg 176:590-596, 1972;.
11 +
Kirkendall WM, Fitz AE, Lawrence MS:  Renal hypertension: Diagnosis and surgical treatment . N Engl J Med 276:479-485, 1967;.
12 +
Luke RG, et al:  Results of surgery in hypertension due to renal artery stenosis . Br Med J 2:76-80, 1968;.
13 +
Hunter JA, Wilcox HG, Kark RM:  Problems in the treatment of renovascular hypertension . Surg Clin North Am 47:91-107, 1967;.
14 +
Hunt JC, et al:  Diagnosis and management of renovascular hypertension . Am J Cardiol 23:434-445, 1969;.
15 +
Blaufox MD, et al:  Peripheral plasma renin activity in renal-homotransplant recipients . N Engl J Med 275:1165-1168, 1966;.
16 +
Sullivan JM, Nakano KK, Tyler HR:  Plasma renin activity during levodopa therapy: Significance of long- and short-term treatment . JAMA 224:1726-1729, 1973;.
17 +
Boucher R, et al:  New procedures for measuring the human plasma angiotensin and renin activity levels . Can Med Assoc J 90:194-201, 1964;.

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