Hypertension/High Blood Pressure Health Center

What Is Renal Hypertension?

Treatments for Renal Hypertension

Medications are used first to try to control high blood pressure in renal hypertension. The most important blood pressure medications to treat renal hypertension include:

• ACE inhibitors (angiotensin converting enzyme inhibitors). These include lisinopril, captopril, benazepril, ramipril, and others.
• ARBs (angiotensin II receptor blockers). Examples include valsartan, losartan, candesartan, and olmesartan.

For most people with renal hypertension due to renal artery narrowing, medications can effectively control blood pressure. More than one blood pressure drug is often needed, however.

In some people with renal hypertension due to narrowing of the renal artery, even taking three or more medications every day cannot adequately control blood pressure. In these situations, a procedure to improve blood flow to the kidneys can often help.

Possible procedures include the following.

Angioplasty. A doctor threads a catheter through a large artery in the groin and advances it into the renal artery. A balloon is then inflated for a few moments. This widens the artery and improves blood flow.

Stenting. During angioplasty, a wire-mesh stent can be expanded inside the renal artery. The stent stays in place. This keeps the artery open after the balloon is removed. In general, stenting is more effective than angioplasty at improving blood flow to the kidney.

Surgery. A surgeon can bypass the narrowed renal artery by sewing a healthy blood vessel next to it. Surgery is generally considered only when angioplasty and stenting are not possible.

These procedures are similar to those used to improve blood flow in the heart in people with coronary artery disease.

Results of Treatment

Blood pressure improves in many people who have a procedure or surgery for renal hypertension. After the procedure, some may be able to stop taking blood pressure medicines entirely.

Surgery is generally the most effective at correcting renal hypertension. Stenting is also effective. But the procedure may need to be repeated to have a lasting result. Angioplasty is somewhat less effective than stenting or surgery. Generally, procedures are more effective when only one kidney's artery is narrowed rather than both.