Diagnostic Approach to Secondary Hypertension: Atherosclerotic Renal Artery Stenosis

Secondary hypertension stems from identifiable causes, making targeted treatment essential to control blood pressure (BP) and mitigate the occurrence of complications. We describe a case of resistant hypertension in a 48-year-old male referred to the internal medicine clinic for investigation. A complementary study with abdominal and pelvic computed tomography revealed significant aortic atherosclerosis involving the emergence of the renal arteries, with particularly evident stenosis on the right. Following vascular intervention, the patient's BP stabilized with just two antihypertensive agents at reduced doses. This case illustrates how extensive renal artery atherosclerosis can cause significant stenosis, leading to secondary hypertension.