J Lipid Atheroscler.  2013 Jun;2(1):37-40. 10.12997/jla.2013.2.1.37.

Importance of Clinical Evaluations Related to Secondary Hypertension in Patients with Resistant Hypertension

• Kim JH
• Park SH
• Ji AY
• Lee JH
• Jin M
• Song C
• Kim I
• Kim YJ
• Lee MH

• KMID: 2095093
• DOI: http://doi.org/10.12997/jla.2013.2.1.37

Abstract

Resistant hypertension is defined as poorly controlled status of blood pressure despite of optimal use of three or more antihypertensive drugs of different classes, including diuretics. Although exact prevalence of resistant hypertension is not known, it has been reported to be 12.8% among patients treated with antihypertensive drugs. It is important to evaluate a possible secondary cause in patients with resistant hypertension. We report a case of resistant hypertension with renal artery segmental stenosis that was not revealed in renal Doppler study. Blood pressure of the patient was well controlled after renal balloon angioplasty.

Keyword

Renal artery segmental stenosis; Secondary hypertension; Resistant hypertension

MeSH Terms

Angioplasty, Balloon
Antihypertensive Agents
Blood Pressure
Constriction, Pathologic
Diuretics
Humans
Hypertension
Prevalence
Renal Artery
Antihypertensive Agents
Diuretics

Figure

• 

  Fig. 1 Adrenal computer tomography (CT) with contrast. CT showed decrease in perfusion of left mid and lower pole of the kidney.

• 

  Fig. 2 Renal angiogram. Prior to angioplasty, left renal angiogram showed segmental stenosis up to 85% (A). The lesion was checked by IVUS to confirm the severity due to tortuosity. After balloon angioplasty was done, final angiogram revealed <30% residual stenosis without dissection (B).

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