ABSTRACT
This chapter focuses on ‘isolated’ renovascular abnormalities as the cause of hypertension. The most important causes of such abnormalities are atherosclerosis and fibromuscular dysplasia (FMD). Renal FMD is the non-atheromatous, non-inflammatory counterpart of atherosclerotic renal artery stenosis (ARAS) and in 85% of cases is due to medial hyperplasia of small and medium size arteries. FMD is a proteiform disease in that the typical multifocal and unifocal stenoses are associated in about 40% of cases with other vascular malformations such as aneurysms or dissections. ARAS and renal FMD differ with respect to patient characteristics and prognosis. In 2016, an expert panel systematically reviewed all data concerning the comparative effectiveness and safety of percutaneous transluminal renal angioplasty plus stenting, surgical revascularization, and medical therapy to treat ARAS in regard to clinically important outcomes. All patients with hypertension associated with renal artery stenosis should be treated intensively with medical therapy. Unfortunately, there is no consensus on the optimal medical treatment.
