Hypertension: listening for abdominal bruits was sometimes helpful for diagnosis.

Clinical bottom line (level 2a)

In patients with diastolic blood pressure 120 mmHg or more, systolic and diastolic abdominal bruits made renovascular hypertension much more likely (LR+39) .
Any epigastric, flank or systolic bruit made renovascular hypertension slightly more likely, but was not very helpful in diagnosis.

Turnbull : Journal of the American Journal of Medicine 1995; 274 (16): 1299-1301

Expires December 2003

The study

Setting: systematic review of diagnostics literature (details of review methodology not expounded)

435 patients hypertension, evaluation for renovascular disease, assessed in three separate studies

Diagnostic test: abdominal auscultation bruits

The evidence

pre-test probability of renovascular hypertension: 10%, (95% CI: % to %)

diagnostic test	renovascular hypertension	other cause for hypertension	LR+ (95% CI)	post-test probability	LR- (95% CI)	post-test probability
systolic and diastolic abdominal bruit	25	2	39 (9.5 to 160)	87%	0.62 (0.51 to 0.75)	6.2%
any epigastric or flank bruit	17	9	6.4 (3.2 to 13)	42%	0.41 (0.25 to 0.68)	4.4%
systolic bruit			2.1 ( to )	19%	0.35 ( to )	3.7%
total

Not enough data was supplied to calculate the confidence intervals for systolic bruit only.

Comments

Results were taken from individual studies. No summative numbers are given.

Citation

Turnbull JM, : Is listening for abdominal bruits useful in the evaluation of hypertension?. Journal of the American Journal of Medicine 1995; 274 (16): 1299-1301

Contributor: Clare Wotton and Bob Phillips, December 2000
Reviewer:

_{Clinical Question.}

_Patient	_hypertension
_{Intervention or Exposure}	_{listening for abdominal bruits}
_Outcome	_{diagnosis renovascular hypertension}