ABSTRACT
Hypertension (high blood pressure) is extremely common and is a major risk factor for coronary artery disease, heart failure and brain haemorrhage. Most patients with serious renal disease are hypertensive. Conversely, most patients with high blood pressure do not have renal disease, leaving aside for the moment the argument that unexplained hypertension (so-called essential hypertension) which is overwhelmingly the most common variety, may have as its underlying cause a renal abnormality. It is unrealistic to expect all patients with hypertension to be referred to a specialist physician, still less to a specialist nephrologist. Referral is indicated if symptoms or signs of renal disease are present, or if a surgically correctable endocrine or renal cause for high blood pressure (such as overactivity of the adrenal glands in the former case and narrowing of a renal artery causing hypertension in the latter case) are suspected.
