Summary

Renovascular hypertension (RVH), defined by the presence of hypertension and significative renal artery stenosis, is the main potentially curable cause of arterial hypertension. The most frequent etiology of RVH is atherosclerosis, fibrodysplasia and arteritis. Activation of the renin-angiotensin system due to reduced renal perfusion resulting from renal artery stenosis contributes to the physiopathology of RVH. Renovascular hypertension can be suspected if there are suggestive clinical findings as refractory hypertension, new-onset hypertension before the age of 20 years or over the age 60 years, and in hypertension associated to unexplained renal failure. Screening for RVH includes renal scintigraphy with captopril, Captopril test and duplex scan of renal arteries. More recently, new non-invasive techniques as vascular magnetic resonance have been used to identify renal artery stenosis. However, renal arteriography remains the gold standard for diagnosing renal artery stenosis. The early diagnosis of RVH can permit a more adequate therapeutic approach and better responses to the treatment.