What are the indications for surgery in hypertension (high blood pressure)?

Updated: Feb 22, 2019
  • Author: Matthew R Alexander, MD, PhD; Chief Editor: Eric H Yang, MD  more...
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Answer

Aortorenal bypass using a saphenous vein graft or a hypogastric artery is a revascularization technique for renovascular hypertension that has become much less common since the advent of renal artery angioplasty with stenting. Surgical resection is the treatment of choice for pheochromocytoma and for patients with a unilateral solitary aldosterone-producing adenoma, because hypertension is cured by tumor resection. Of note, patients with benign adenomas may be able to be treated with spironolactone instead of surgery. In patients with fibromuscular renal artery disease, angioplasty has a 60-80% success rate for improvement or cure of hypertension. Another intervention that initially seemed to hold great promise for the treatment of resistant hypertension is renal artery denervation. However, more recent controlled studies have suggested little benefit on BP from percutaneous renal denervation therapy, and ongoing studies are testing this intervention using newer techniques. [76]


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