Атеросклероз почечных артерий (атеросклеротическая реноваскулярная болезнь, ARVD) — сосудистое проявление системного атеросклероза с поражением почечных артерий. Лечение первой линии направлено на снижение сердечно-сосудистого риска и нормализацию артериального давления в соответствии с пороговыми значениями, рекомендованными ведущими профессиональными обществами.
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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