What is the role of medications in the treatment of renovascular hypertension (RVHT)?

Updated: Dec 01, 2020
  • Author: Rebecca J Schmidt, DO, FACP, FASN; Chief Editor: Vecihi Batuman, MD, FASN  more...
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Answer

Medical treatment of renovascular hypertension (RVHT) may be necessary to control blood pressure until surgery can be performed. Attempts should be made to reduce the blood pressure before surgery so as to improve the likelihood of a good surgical outcome. Afterward, medical treatment is necessary 25-30% of the time to provide complete resolution of improved or refractory hypertension.

Adrenergic receptor blockers and diuretics are the preferred agents. Arterial dilators are also useful in the preoperative management of malignant hypertension. Calcium channel blockers do not seem to be as widely used, and angiotensin-converting enzyme (ACE) inhibitors are generally avoided because of their potential to compromise renal function.


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