Emerging approaches in secondary hypertension due to renal artery stenosis: evaluation and treatment - systematic review

Abstract

Hypertension, a global health concern, affects a staggering 1.28 billion people worldwide, as stated by the World Health Organization (WHO) however renal artery stenosis (RAS), a common cause of secondary hypertension, is characterized by the narrowing of renal arteries, leading to physiological changes such as arterial stiffening and elevated blood pressure. The major causes of RAS include atherosclerosis and fibromuscular dysplasia. Diagnosis involves clinical suspicion and imaging studies such as Doppler ultrasonography and angiography. Treatment strategies encompass lifestyle modifications, pharmacotherapy, interventional procedures like angioplasty with stenting, and emerging options such as renal denervation and gene therapy. Our aim is to provide a comprehensive examination of the pathophysiology, prevalence, risk factors, causes, diagnosis, and treatment modalities through a systematic search gathering qualitative and quantitative data. We address the challenges in diagnosis and treatment, emphasizing the need for tailored approaches considering patient-specific factors. We will review emerging approaches in evaluating and treating secondary hypertension due to RAS.