Clinical Snapshot
Hypertension Secondary to Fibromuscular Dysplasia of the Renal Arteries
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In the first half of 2024, a 40-year-old female patient developed recurrent episodes of blood pressure dysregulation and difficult-to-manage hypertension. In the course of further investigation in the diagnostic work-up, ultrasound prompted the suspicion of right-sided renal artery stenosis, possibly secondary to fibromuscular dysplasia (FMD). The patient underwent invasive angiography with the team on standby for intervention. Angiographic visualization of the renal artery confirmed the suspicion of FMD (Figure a). FMD is the second most common cause of renal artery stenosis after arteriosclerosis and the most common cause of renal hypertension in young people. Angioplasty of the renal artery was performed, which improved the angiographic picture (Figure b). Postinterventional follow-up with duplex ultrasound showed improved renal artery perfusion, although it was not yet possible to reduce the patient’s pre-existing triple antihypertensive medication. Further follow-up is planned. FMD is a rare vascular disease that primarily affects females and can lead to segmental narrowing of the arteries, thereby causing, in particular, high blood pressure and vascular complications. Treatment consists of antihypertensive drugs and, where necessary, angioplasty interventions.
In the first half of 2024, a 40-year-old female patient developed recurrent episodes of blood pressure dysregulation and difficult-to-manage hypertension. In the course of further investigation in the diagnostic work-up, ultrasound prompted the suspicion of right-sided renal artery stenosis, possibly secondary to fibromuscular dysplasia (FMD). The patient underwent invasive angiography with the team on standby for intervention. Angiographic visualization of the renal artery confirmed the suspicion of FMD (Figure a). FMD is the second most common cause of renal artery stenosis after arteriosclerosis and the most common cause of renal hypertension in young people. Angioplasty of the renal artery was performed, which improved the angiographic picture (Figure b). Postinterventional follow-up with duplex ultrasound showed improved renal artery perfusion, although it was not yet possible to reduce the patient’s pre-existing triple antihypertensive medication. Further follow-up is planned. FMD is a rare vascular disease that primarily affects females and can lead to segmental narrowing of the arteries, thereby causing, in particular, high blood pressure and vascular complications. Treatment consists of antihypertensive drugs and, where necessary, angioplasty interventions.
Dr. med. Jan Izbicki, Bernhard Schmuck, Dr. med. Frank Marquardt, Klinik für Gefäßchirurgie, Rotes Kreuz Krankenhaus Bremen,
izbicki.j@roteskreuzkrankenhaus.de
Conflict of interest statement: The authors state that no conflict of interest exists.
Translated from the original German by Christine Rye.
Cite this as: Izbicki J, Schmuck B, Marquardt F: Hypertension secondary to fibromuscular dysplasia of the renal arteries. Dtsch Arztebl Int 2025; 122: 179. DOI: 10.3238/arztebl.m2024.0252
