[Fibromuscular renovascular hypertension: comparison of surgery, transluminal dilatation and drug therapy].

82 patients with fibromuscular renovascular hypertension have been studied. 33 patients were treated surgically (group I), 28 underwent transluminal dilation (group II) and 21 received drug treatment (group III). After a follow-up period of 2.5 (0.1-7) years, blood pressure in group I had decreased from 207 +/- 27/128 +/- 17 mm Hg to 135 +/- 15/85 +/- 9 mm Hg after surgery (p less than 0.001). 1.3 (0.1-4) years after dilation, group II showed a decrease of blood pressure from 174 +/- 25/107 +/- 13 mm Hg to 143 +/- 26/88 +/- 12 mm Hg (p less than 0.001). Blood pressure in group III decreased under drug therapy from 203 +/- 41/122 +/- 16 mm Hg to 146 +/- 19/92 +/- 8 mm Hg (p less than 0.001). 52% of the surgical patients and 50% of the dilated patients were cured, whereas 45% and 39% respectively were improved and 3% and 11% respectively did not improve. In group III, under antihypertensive drug therapy, blood pressure normalized in 62% of the patients, 33% showed better values and 5% did not improve. The complication rate was 11% in group I and 3.3% in group II. In two patients dilation was technically impossible. In group III one patient (4.8%) showed a massive but reversible increase of serum creatinine under captopril. In 70% of all patients the renal vein renin ratio was greater than or equal to 1.5. However, this ratio was unreliable as a parameter to predict the blood pressure decrease with curative methods. It is concluded from the above that all three methods offered good to very good results.(ABSTRACT TRUNCATED AT 250 WORDS)