We have reviewed thirty-three cases of accelerated hypertension associated
with chronic total renal artery occlusion. During the process of progressiv
e narrowing of the arterial lumen until complete occlusion, an exceptionall
y elevated blood pressure occurs when a critical reduction of renal blood f
low is attained. Then the patient presents one or more of the following cli
nical manifestations: III-IV grade KWB retinal changes, hypertensive enceph
alopathy including convulsive attacks, stroke, heart failure, renal insuffi
ciency.
We have called this clinical event 'hypertensive vascular crisis'. Mostly i
n older patients an actual or anamnestic vascular crisis makes a diagnosis
of chronic total renal artery occlusion highly probable.