La aterosclerosis de la arteria renal (enfermedad renovascular aterosclerótica, ARVD) es una manifestación vascular de la aterosclerosis sistémica que afecta las arterias renales. El manejo de primera línea tiene como objetivo la reducción del riesgo cardiovascular junto con el control de la presión arterial, siguiendo los umbrales recomendados por múltiples sociedades científicas de referencia.
Intensive management of arterial hypertension is the single most important and modifiable cardiovascular risk factor, with the latest American Heart Association/American College of Cardiology and European Society of Cardiology guidelines recommending a target blood pressure <130/80 mm Hg and KDIGO recommending systolic blood pressure <120 mm Hg.
Initial antihypertensive therapy often includes multiple drugs, but RAAS blockers are preferred.
Hence, RAAS blockade is recommended in the setting of ARVD.
Lipid-lowering drugs are strongly recommended to achieve cholesterol targets appropriate to the level of cardiovascular risk; by definition, ARVD represents a clinical manifestation of atherosclerotic disease and should be considered to pose very high risk.
Antiplatelet therapy with at least a low dose of aspirin is also considered as standard care for secondary prevention of cardiovascular events.
Additional measures to manage ARVD risk include tobacco cessation and glycemic control.
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