David G. Martinez, MD
Martinez DG. Screening for Renovascular Hypertension. Ann Intern Med. 1993;118:905-906. doi: 10.7326/0003-4819-118-11-199306010-00016
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Published: Ann Intern Med. 1993;118(11):905-906.
TO THE EDITOR:
Mann and Pickering  correctly recommend screening for renovascular hypertension only in patients with a moderate or high suspicion of the disease . Other determining factors for screening, however, include the patient's willingness to have treatment if renovascular disease is found and the physician's willingness to pursue treatment based on the patient's risk profile and ease of hypertension control.
In the best of hands, surgical mortality for repair of atheromatous renovascular disease is 2%  and may approach 9.3% . Many of these patients have coronary artery disease or peripheral vascular disease, use tobacco, or have chronic obstructive pulmonary disease, which may further increase surgical risk. Furthermore, up to one third of patients with hypertension from atheromatous renovascular disease exhibit no improvement in control from surgical repair . High-risk patients can often have their hypertension controlled with minoxidil and a diuretic.
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Print ISSN: 0003-4819 | Online ISSN: 1539-3704
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