Document Detail


Medical treatment of renal artery stenosis: is it effective and appropriate?
MedLine Citation:
PMID:  16251844     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Recent advances in endovascular technology have radically changed the options available for the clinical management of the patient with renovascular disease. These treatment options have fueled an ongoing debate concerning the appropriateness of interventional endovascular therapy for the stenotic renal artery versus conservative medical management. This review examines a typical clinical case scenario and analyzes relevant published literature and the recent guidelines from the Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC 7) highlighting the significant shortcomings of evidence-based data when it comes to the management of this complex patient population. Early diagnosis provides the best opportunity for appropriate utilization of therapeutic options and rational timing of deployment of interventional techniques. Recommendations for conservative medical management are made based on the review of the medical management arms of the published interventional series. In addition, suggestions are made for practical modifications to the JNC 7 hypertension management protocol to better address the challenging diagnostic and management issues raised by the renovascular patient.
Authors:
Andrew B Covit
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Publication Detail:
Type:  Case Reports; Journal Article; Review    
Journal Detail:
Title:  Journal of hypertension. Supplement : official journal of the International Society of Hypertension     Volume:  23     ISSN:  0952-1178     ISO Abbreviation:  J Hypertens Suppl     Publication Date:  2005 Oct 
Date Detail:
Created Date:  2005-10-27     Completed Date:  2006-05-02     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8501422     Medline TA:  J Hypertens Suppl     Country:  England    
Other Details:
Languages:  eng     Pagination:  S15-22     Citation Subset:  IM    
Affiliation:
UMDNJ-Robert Wood Johnson Medical School, Division of Nephrology and Hypertension, New Brunswick, New Jersey 08882, USA. acovit@nephrohibp.com
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MeSH Terms
Descriptor/Qualifier:
Aged
Antihypertensive Agents / therapeutic use*
Humans
Hypertension, Renovascular / drug therapy*,  etiology
Male
Patient Selection
Renal Artery Obstruction / complications,  drug therapy*,  surgery
Treatment Outcome
Chemical
Reg. No./Substance:
0/Antihypertensive Agents

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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