A well-recognized cause of secondary hypertension is renal artery stenosis (RAS), but uncertainty exists regarding whether it is worthwhile to actively search for this condition. First, the diagnosis of RAS requires either an invasive procedure (digital subtraction angiography [DSA]) or a noninvasive yet costly investigation such as magnetic resonance angiography (MRA) or CT angiography (CTA). One shared disadvantage of the latter two methods is that it is necessary to administer contrast material to the patient. Second, it is not so easy to select for further study those patients in whom a reasonable chance of finding a stenotic lesion exists. Finally, an effective treatment must be available in order to justify screening for RAS.
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