Hipertensión renovascular de origen ateroesclerótico. Diagnóstico y avances terapéuticos.
Resumen
La hipertensión arterial renovascular (HARV) es una de las causas prevalentes de hipertensión arterial secundaria (HTA) contribuyendo a la causa de morbimortalidad cardiovascular y renal. El envejecimiento de la población y los factores de riesgo cardiovasculares no adecuadamente controlados favorecen la aparición más frecuente de hipertensión arterial renovascular ateroesclerótica. Es frecuente que el médico clínico piense en esta eventualidad por lo que es necesario conocer las herramientas diagnósticas no invasiva e invasivas que actualmente están en uso para el diagnóstico y la evaluación del paciente con HARVA. Los resultados de distintos estudios randomizados publicados en los últimos años han posibilitado el cambio de algunas actitudes terapéuticas, jerarquizándose el tratamiento médico de la HTA y de los factores que condicionan la progresión de la ateroesclerosis, una de cuyas consecuencias es la estenosis de la arteria renal. Las decisiones médicas deberán basarse en un análisis individual de cada paciente acorde a su complejidad y a la experiencia de cada centro.
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