American Board of Pathology (ABPath) 2025 – 400 Free Practice Questions to Pass the Exam

Renal artery stenosis is recognized as one of the most common correctable causes of hypertension primarily due to its impact on renal perfusion and subsequent activation of the renin-angiotensin-aldosterone system (RAAS). In this condition, a narrowing of the renal artery restricts blood flow to the kidney, prompting the kidney to release renin. This leads to an increase in angiotensin II, resulting in vasoconstriction and increased blood pressure, as well as stimulation of aldosterone secretion which promotes sodium and water retention, further elevating blood pressure.

The correctability aspect comes from the potential for surgical intervention, such as renal artery angioplasty or stenting, which can restore normal blood flow and potentially lead to a significant reduction in blood pressure. This contrasts with other conditions like chronic kidney disease, which can complicate blood pressure regulation without a clear, universally applicable corrective intervention, or obstructive sleep apnea that might require lifestyle changes or CPAP but isn't solely focused on a single anatomical abnormality. Hyperaldosteronism, while it can be treated medically or surgically, tends to be less prevalent compared to renal artery stenosis as a cause of secondary hypertension. In summary, renal artery stenosis stands out due to