Renovascular hypertension in Afro-Americans and White patients

Q: Renovascular hypertension is more common in? (select one)

A) Afro-Americans patients

B) Caucasian patients

Answer: B

Any white male who developed severe hypertension (HTN) after age 55 should be evaluated for rnovascular etiology. Fortunately, it is correctable. Risk factors include previous history of HTN, hypertensive retinopathy, coronary artery disease, and peripheral arterial and aortic disease.

For poorly understood reason, renovascular disease is more common in white patients. It should be noted that this disparity may have some component of referral bias.

Interestingly, the complications of renovascular disease, if develop in a black patient is considerably more severe such as refractory hypertension, stroke or myocardial infarction.

#cardiovascular

#epidemiology

References:

1. Lewin A, Blaufox MD, Castle H, et al. Apparent prevalence of curable hypertension in the Hypertension Detection and Follow-up Program. Arch Intern Med 1985; 145:424.

2. Davis BA, Crook JE, Vestal RE, Oates JA. Prevalence of renovascular hypertension in patients with grade III or IV hypertensive retinopathy. N Engl J Med 1979; 301:1273.

3. Novick AC, Zaki S, Goldfarb D, Hodge EE. Epidemiologic and clinical comparison of renal artery stenosis in black patients and white patients. J Vasc Surg 1994; 20:1.