Renovascular hypertension: can we identify a population at high risk?

Renovascular hypertension is a common cause of secondary hypertension. However, diagnostic tests are limited by lack of sensitivity and specificity, cost, or invasiveness. Selecting patients with hypertension for evaluation of renal artery stenosis can be challenging. This review focuses on the sensitivity and specificity of commonly used screening tests for renal artery stenosis and on the clinical variables that are most likely to distinguish patients with renal artery stenosis from patients with other causes of their hypertension. This approach allows for the rational screening of patients at high and moderate risk for renal artery disease.