Peripheral Arterial Disease (PAD) Expert Forum
RAS
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Questions in the Peripheral Arterial Disease forum are answered by Dr. Lee Kirksey, associate professor at The University of Pennsylvania School of Medicine. Topics covered include abdominal aortic aneurysm , amputation, arteriovenous fistula, atherectomy, carotid artery surgery , cholesterol , claudication, deep vein thrombosis (DVT) , endovascular aortic stent graft (EVAR), stent placement , stroke prevention, varicose veins , and venous insufficiency .

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RAS

I have always had normal blood pressure, 110-120/60-70 until the last few months. My pressure suddenly went up to 150-170/90-110 sometime between March and May of this year. My doctor put me on 160mg Diovan, and the pressure has decreased, but not to my normal levels. I do not smoke (last 5 years) or drink, and exercise regularly (weights). I am not overweight, I am 49 yrs old. I do have atherosclerosis (PAD). My doctor ordered a blood work up and a regular ultrasound of my kidneys, but nothing was found. I did some research, and Renal artery stenosis seemed likely to pertain to my situation (with PAD hitory). Are there any other causes I could discuss with my doctor? Thanks
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Hi Steve
The consideration of RAS as a cause of your new onset hypertension is appropriate.
Ultrasound is the testing modality but it has to be ordered by stating what problem is being evaluated to get the correct information. A general ultrasound for kidney disease may look only at kidney size while a vascular ultrasound for RAS evaluates velocity within the renal arteries as well as resistance within the blood vesses and a renal artery to aortic velocity ratio.  Discuss what information was looked for on the ultrasound with your doctor and make sure that the lab evaluating you is ICAVL accredited for vascular ultrasound. This increases the chance of a quality test as ultrasound is very technologist dependent. thanks and good luck
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Thank you . I saw my Doctor today, and asked to be referred to a Nephrologist. I have an appointment in a month. I will discuss with her the options you mentioned. Thanks very much for your help.
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