Spectrum of renovascular hypertension in the young in north India: a hospital based study on occurrence and clinical features.

Occurrence of renovascular hypertension and its etiology is described in this work as seen in north India. Out of 2395 young hypertensives admitted for evaluation during the years 1978-1983, 91 patients (3.8%) were found to be having renovascular hypertension. In all patients suspected diagnosis of RVH was confirmed by the angiography of aorta and main vessels. Idiopathic aortoarteritis, diagnosed in 54 patients (59.4%) was the commonest cause of renovascular hypertension. In this group renal arterial involvement was found to be bilateral in 26 patients. Twenty-eight patients had isolated renal artery stenosis of unknown etiology. Six had fibromuscular dysplasia, 2 had polyarteritis and one had renal artery aneurysm. Twenty-three patients underwent surgery which included autotransplantation, arterial by-pass and nephrectomy with improved blood pressure control in 15. It is concluded that aortoarteritis seems to be the major cause of renovascular hypertension in the young in this part of the world.