L'athérosclérose des artères rénales (maladie rénovasculaire athérosclérotique, ARVD) est une manifestation vasculaire de l'athérosclérose systémique impliquant les artères rénales. La prise en charge de première intention vise à réduire le risque cardiovasculaire tout en contrôlant la pression artérielle, selon les seuils recommandés par les directives de plusieurs grandes sociétés savantes.
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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