Digital Subtraction Angiography in the Evaluation of Hypertension

Renal artery stenosis is the most common etiology for secondary hypertension, being responsible for an estimated 5-10% of all chronic blood pressure elevation. In recent years, however, patterns of medical practice generally have disdained case-finding for renovascular hypertension in favor of relatively indiscriminate medical therapy, except in cases of unusual presentation. The arguments favoring this approach have focused on the unreliability of radiographic screening methods for detecting renal artery stenosis, the expense of identifying and treating individuals with these lesions, and the morbidity and mortality associated with diagnosis and therapy.