Title

ACR Appropriateness Criteria((R)) Renovascular Hypertension

UMMS Affiliation

Department of Radiology

Publication Date

11-1-2017

Document Type

Article

Disciplines

Cardiovascular Diseases | Female Urogenital Diseases and Pregnancy Complications | Male Urogenital Diseases | Radiology | Urology

Abstract

Renovascular hypertension is the most common type of secondary hypertension and is estimated to have a prevalence between 0.5% and 5% of the general hypertensive population, and an even higher prevalence among patients with severe hypertension and end-stage renal disease, approaching 25% in elderly dialysis patients. Investigation for renal artery stenosis is appropriate when clinical presentation suggests secondary hypertension rather than primary hypertension, when there is not another known cause of secondary hypertension, and when intervention would be carried out if a significant renal artery stenosis were identified. The primary imaging modalities used to screen for renal artery stenosis are CT, MRI, and ultrasound, with the selection of imaging dependent in part on renal function. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision include an extensive analysis of current medical literature from peer reviewed journals and the application of well-established methodologies (RAND/UCLA Appropriateness Method and Grading of Recommendations Assessment, Development, and Evaluation or GRADE) to rate the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where evidence is lacking or equivocal, expert opinion may supplement the available evidence to recommend imaging or treatment.

Keywords

AUC, Appropriate Use Criteria, Appropriateness Criteria, CT, MRI, Renal artery stenosis, Renovascular hypertension, US

DOI of Published Version

10.1016/j.jacr.2017.08.040

Source

J Am Coll Radiol. 2017 Nov;14(11S):S540-S549. doi: 10.1016/j.jacr.2017.08.040. Link to article on publisher's site

Journal/Book/Conference Title

Journal of the American College of Radiology : JACR

Comments

Full author list omitted for brevity. For the full list of authors, see article.

Related Resources

Link to Article in PubMed

PubMed ID

29101991

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