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The first treatment step involves controlling the high blood pressure with medication.
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Medications that may be used in an attempt to control blood pressure include diuretics, beta blockers, calcium channel blockers, angiotensin-converting enzyme inhibitors, angiotensin receptor blockers (ARBs) and alpha blockers.
Response to medications is highly individual. Blood pressure should be monitored frequently. Medication and dosage may need frequent adjustment.
Further mangement of the disease depends on its underlying cause. In some cases, surgical reconstruction of a damaged artery may be performed. Patients with fibromuscular dysplasia, a vascular disease that causes narrowing of the renal arteries, may benefit from percutaneous transluminal renal angioplasty (PRTA) using a stent. This cures hypertension in a good percentage of patients, and makes it easier to control in the rest.
Most nephrologists will attempt to a surgical bypass of the renal arteries (revascularization) to restore blood flow in patients who have severe, refractory hypertension, episodes of flash pulmonary edema or rapid progression of renal failure.
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