Bilateral renal artery stenosis (RAS) causing recurrent hypertensive emergency and pulmonary oedema is difficult to manage. Use of angiotensin converting enzyme inhibitors (ACEi) II receptor blockers (ARB) usually contraindicated. We present a systematic review literature case vignette which highlights the useful properties this mineralocorticoid antagonists (MRAs) in scenario.

OBJECTIVE To determine the effect of combinations of statins, aspirin, beta blockers, and angiotensin converting enzyme inhibitors in the secondary prevention of all cause mortality in patients with ischaemic heart disease. DESIGN Open prospective cohort study with nested case-control analysis. SETTING 1.18 million patients registered with 89 general practices across 23 strategic health aut...