Diagnosis and management of systemic hypertension due to renovascular and aortic stenosis in patients with Williams-Beuren syndrome

Rev Assoc Med Bras (1992). 2018 Aug;64(8):723-728. doi: 10.1590/1806-9282.64.08.723.

Abstract

Aim: To describe the incidence, diagnosis, and management of systemic arterial hypertension related to renal artery stenosis in patients with Williams-Beuren syndrome.

Methods: Sixty-five patients with Williams-Beuren syndrome were evaluated for hypertension. Enrolled patients underwent Doppler sonography of the renal arteries and Doppler echocardiography. Those with Doppler sonography-detected lesions or with normal Doppler sonography but severe hypertension underwent computed tomography or gadolinium-enhanced magnetic resonance angiography of the aorta and renal vessels. Patients needing vascular therapeutic intervention underwent conventional angiography.

Results: Systemic arterial hypertension was diagnosed in 21/65 patients with Williams-Beuren syndrome (32%; 13 male) with a mean age of 13.9 years (5mo-20yrs). In 8/21 patients renovascular hypertension was detected. Angioplasty was unsuccessful in five patients with renal artery stenosis, requiring additional treatment. Doppler echocardiography showed cardiac abnormalities in 16/21 (76%) hypertensive patients.

Conclusion: Cardiac abnormalities and hypertension in patients with Williams-Beuren syndrome are common. Thus, thorough evaluation and follow-up are necessary to reduce cardiovascular risks and mortality of these patients.

MeSH terms

  • Adolescent
  • Adult
  • Brazil / epidemiology
  • Child
  • Child, Preschool
  • Echocardiography, Doppler
  • Female
  • Humans
  • Hypertension / diagnostic imaging
  • Hypertension / epidemiology
  • Hypertension / etiology*
  • Incidence
  • Infant
  • Magnetic Resonance Angiography
  • Male
  • Prospective Studies
  • Renal Artery Obstruction / complications*
  • Renal Artery Obstruction / diagnostic imaging
  • Renal Artery Obstruction / epidemiology
  • Ultrasonography, Doppler
  • Williams Syndrome / complications*
  • Williams Syndrome / diagnostic imaging
  • Williams Syndrome / epidemiology
  • Young Adult