RENOVASCULAR HYPERTENSION IN BLACKS

To define the clinical characteristics of renovascular hypertension (R VH) and determine the clinical usefulness of captopril stimulated peri pheral renin and postcaptopril renography in blacks at risk for RVH, 7 9 clinically selected hypertensive blacks were evaluated. Unstimulated (U-PRA), captopril stimulated (S-PRA) peripheral renin, and postcapto pril renography (PC-RENO) were obtained. All subjects underwent conven tional renal arteriography. Renal artery stenosis (RAS) was present in 14 of 79 (18%) patients. Renovascular hypertension (RVH) was found in 7 of 79 (9%) patients. S-PRA had a sensitivity and specificity of 38% and 86% respectively to detect RAS; and a sensitivity and a specifici ty of 17% and 85% respectively to detect RVH. PC-RENO had a sensitivit y and a specificity of 64% and 58% respectively to detect RAS; and a s ensitivity and a specificity of 67% and 58% respectively to detect RVH . This study suggests that RAS occurs in 18% of clinically selected hy pertensive blacks. RVH was present in 9% of this population. Captopril stimulated peripheral renin and postcaptopril renography are not usef ul as screening tools for the diagnosis of renovascular disease in bla cks. Blacks at high risk should be evaluated with angiography.