Which finding most supports renal artery stenosis as a cause of secondary hypertension?

• A. Abdominal bruit
• B. Hyperkalemia
• C. Low BUN
• D. Hypernatremia

Answer: (A)

Renovascular hypertension stems from reduced blood flow to the kidneys, which triggers renin release and activation of the angiotensin-aldosterone system, driving high blood pressure. The most supportive finding is an abdominal bruit, produced by turbulent flow through a narrowed renal artery. This vascular sound points to an underlying stenosis causing the secondary hypertension.

Hyperkalemia is not a typical clue here because aldosterone tends to promote potassium loss, not retention. A low BUN isn’t characteristic of renovascular disease, and hypernatremia isn’t a specific indicator either. The abdominal bruit directly reflects the vascular abnormality causing the hypertension.