Title
ACR Appropriateness Criteria((R)) Renovascular Hypertension
UMMS Affiliation
Department of Radiology
Publication Date
2017-11-01
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
Related Resources
PubMed ID
29101991
Repository Citation
Expert Panels on Urologic Imaging and Vascular Imaging; Harvin, Howard J.; and Dill, Karin E., "ACR Appropriateness Criteria((R)) Renovascular Hypertension" (2017). Radiology Publications and Presentations. 364.
https://escholarship.umassmed.edu/radiology_pubs/364
Comments
Full author list omitted for brevity. For the full list of authors, see article.