Renovascular hypertension: what is it?
Renovascular hypertension is one of the most common types of hypertension of the arteries, which is also called renal. About 5% of cases of hypertension are renovascular to mind.
In most cases, the cause of renovascular hypertension is atherosclerosis (about 60%), second place belongs to fibromylagia dysplasia (30%).
Renal hypertension: what is it?
When renovascular hypertension is observed the narrowing of the renal artery and its main branches, leading to admission into the kidney of a smaller volume of blood and renal ischemia. The pressure in the kidney and around it will increase due to allocating a large amount of renin, which can lead to stenosis of other major arteries of the body (vessels of the heart, brain, liver, etc.). Disease more susceptible to men who have atherosclerosis of the renal artery in most cases is bilateral and has a tendency to progression and complete occlusion of the arterial lumen.
The types of the disease
Renovascular hypertension are of three types:
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1. Renal parenchymal hypertension is characteristic for patients with concomitant diseases affecting renal parenchyma:
- nephropathy in pregnant women;
- systemic disease of the connective renal tissue.
2. Renovascular (I use) hypertension occurs when changing the diameter of the arteries of the kidneys in the following conditions:
- malformations of the vascular walls;
3. Combined hypertension nephrogenic nature is characterized by a combination of renal parenchymal tissue and atherosclerosis, occur when the following ailments:
- congenital renal and vascular anomalies;
- the omission of the kidneys;
- cysts and renal neoplasms.
The speed of the development of the disease depends on its course, which can be both benign and malignant.
- In benign course of the disease progresses slowly, treatment is possible at home under the supervision of a physician. Pressure of the patient is stable, there is a trend to greater increase in bottom pressure. Patients experience pain in the sternum and the heart. Marked shortness of breath, spinning head and General weakness.
- In malignant disease the symptoms manifest themselves quickly, the patient may need hospitalization. The lower the pressure may rise above the level of 120 mm Hg. article, reduced vision (in severe cases, patients are blinded), they have a severe migraine. The patient has nausea, possible vomiting.
Symptoms of renovascular hypertension:
- sudden, abrupt onset;
- a sharp increase in blood pressure;
- pain in the sacrum and lower back;
- the pressure not to «break» the traditional medicines.
That can detect the doctor during the initial examination:
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- the AD patient (bottom increased more, the difference between them is small);
- systolic murmur in the abdomen (above the navel, at the sides), caused by an increased force of the kidneys;
- the fundus examination will show changes in the pattern, edema, minute hemorrhages.
Additional methods of examination:
The treatment of the disease
In benign course of the disease appropriate conservative medical therapy, including:
- the causal treatment of the disease;
- medications to lock the selection angiotesin-II;
- means to lower production of renin.
If hypertension develops fast and affects the heart, kidneys and brain, then medical therapy will not give the desired effect. In this case shows the radical methods of treatment:
1. Balloon angioplasty of stenotic arteries. In the lumen of the vein catheter with a silicone balloon at its tip. On the tip of the catheter is covered with a stent (microdenture). Reaching the narrowed artery, the balloon is inflated, it «opens» the stent, which is tightly «sits» inside.
2. Surgical intervention is indicated for:
- complex stenosis of the arteries;
- the complete overlap of the venous lumen;
- inefficiency stenting of stenotic arteries.
In some particularly difficult cases, surgeons can completely remove the affected kidney.
In the case where after surgery the blood pressure is normal, no atherosclerosis, the prognosis is favorable. The patient will live a normal life and work.
If there is bilateral narrowing of the gaps, complicated by heart problems, brain and kidney, the possible disability of the patient or death.