Prevalence
Causes
Clinical
features
Investigations
Therapy
Prognosis
|  | | | Clinical
features |
-
renovascular hypertension b
Note:
A clinical diagnosis rule may help predict renovascular disease
|
Clinical features b
|
Score
|
|
|
Age
|
Never smoked
|
Ever smoked
|
|
20
|
0
|
3
|
|
30
|
1
|
4
|
|
40
|
2
|
4
|
|
50
|
3
|
5
|
|
60
|
4
|
5
|
|
70
|
5
|
6
|
|
Female sex
|
2
|
|
Signs and symptoms of atheroscelortic disease (femoral or carotid
bruit, angina pectoris, claudication, myocardial infarction, ischaemic
stroke or vascular surgery)
|
1
|
|
Onset of hypertension within 2 years
|
1
|
|
Body mass index < 25 kg/m2
|
2
|
|
Presence of abdominal bruit
|
|
|
Serum creatinine concentration
|
|
|
40 micromol/l
|
0
|
|
60 micromol/l
|
1
|
|
80 micromol/l
|
2
|
|
100 micromol/l
|
3
|
|
150 micromol/l
|
6
|
|
200 micromol/l
|
9
|
|
Serum cholesterol > 6.5 mmol/l or on cholesterol-lowering therapy
|
1
|
For intermediate values, interpolate the score linearly
Why?
A low potassium makes primary hyperaldosteronism more likely
| Patient |
Target Disorder and
Reference Standard |
Diagnostic Test |
LR+
(95% CI)
|
Post-test Probability |
suspected renovascular disease b
(pre-test probability: 22%)
|
renal artery stenosis
(renal angiography)
|
Score > 15
|
18
(7.3 to 47)
|
85% |
|
|
|
13 to 15
|
5.3
(2.9 to 9.7)
|
62% |
|
|
|
12 to 13
|
2.6
(1.5 to 4.3)
|
44% |
|
|
|
9 to 11
|
0.60
(0.40 to 0.91)
|
15% |
|
|
|
< 9
|
0.22
(0.13 to 0.38)
|
6% |
|
internal medicine