Clinical Characteristics of Renovascular Hypertension

Clinical characteristics of 175 patients with renovascular hypertension cured by surgery were compared with those of 339 patients with essential hypertension. Significant variables included abdominal or flank bruit, age, sex, race, duration and acceleration of hypertension, family history, symptoms, history of arterial occlusive disease outside of the kidney, body habitus, systolic blood pressure, orthostatic change in blood pressure, severity of retinopathy, cardiomegaly, blood urea nitrogen, serum creatinine and cholesterol levels, serum potassium and carbon dioxide contents, urinary casts, proteinuria, and bacteria. Some of the differences between the two populations were no longer apparent after matching 131 pairs of patients according to age, sex, race, and diastolic blood pressure. Patients cured by surgery were compared with patients who were improved, who failed to respond, and who had surgical deaths. In patients with atherosclerotic lesions, those who failed to respond had hypertension of longer duration and were more likely to show left ventricular hypertrophy than the cured patients. Those with surgical death had more widespread atherosclerosis, cardiac damage, and renal functional impairment.