Renovascular hypertension is a form of secondary hypertension caused by renal artery stenosis (most commonly atherosclerosis in older males or fibromuscular dysplasia in young females), which reduces renal perfusion and triggers the renin-angiotensin-aldosterone system (RAAS): decreased perfusion stimulates juxtaglomerular beta-1 receptors to release renin, generating angiotensin II via angiotensin-converting enzyme, which causes efferent arteriolar vasoconstriction (restoring glomerular filtration rate) and stimulates aldosterone-mediated sodium reabsorption, together elevating systemic blood pressure. This mechanism explains why ACE inhibitors are contraindicated in renal artery stenosis (since blocking angiotensin II formation removes the compensatory efferent constriction needed to preserve GFR) while being renal-protective in diabetic nephropathy.
Renovascular hypertension is a form of secondary hypertension caused by renal artery stenosis (most commonly atherosclerosis in older males or fibromuscular dysplasia in young females), which reduces…