Which of the following is a clinical indicator for renal artery angiography?

Renal artery angiography is a diagnostic imaging technique used to visualize the blood vessels of the kidneys, primarily to assess for renal artery stenosis, which can lead to hypertension. The onset of hypertension at an unusual age, specifically prior to age 30 or after age 50, is a clinical indicator that warrants investigation for possible secondary causes of hypertension, including renovascular hypertension due to renal artery stenosis.

Establishing whether hypertension is essential or secondary is crucial in managing a patient's health. When hypertension presents in younger individuals, it raises the suspicion for underlying conditions such as renal artery abnormalities. In this context, renal artery angiography serves as an essential tool for diagnosis.

Other options, while potentially relevant to overall health or vascular risk, do not serve as primary indicators for performing renal artery angiography. While diabetes mellitus can lead to vascular complications and is an important factor in managing overall cardiometabolic risk, it does not specifically indicate the need for renal artery angiography as hypertension does. Similarly, hypothyroidism and family history of heart disease are important clinical considerations but do not directly correlate with the need for renal artery imaging. Hence, the correct choice highlights a specific and significant clinical scenario that justifies renal artery angiography.