Pharmacologic Management of Renovascular Hypertension

doi:10.1001/jama.1974.03230170037011

Pharmacologic Management of Renovascular Hypertension

Mark R. G. Chassin, MD;
Jay M. Sullivan, MD

From the Hypertension Unit, Department of Medicine, Peter Bent Brigham Hospital, and Harvard Medical School, Boston. Dr. Chassin is now with the Department of Medicine, Los Angeles County Harbor General Hospital, Torrance, Calif.

Abstract

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.