Background Renal artery stenosis of atherosclerotic origin frequently coexists with atherosclerotic lesions in other vascular beds (aorta, coronary, carotid and peripheral arteries). Several risk factors contribute to the development of coronary artery disease as well as of renal artery stenosis. The aim of the study was to evaluate atherosclerotic risk factors in patients with essential hypertension and coronary disease with or without renal artery stenosis. The frequency of renal artery stenosis in patients with essential hypertension associated with coronary artery disease was estimated as well.
Material and methods Coronary and renal arteriographies were performed at the same time in 282 patients (200 male, 82 female, age range: 26–82 years) with essential hypertension hypertension associated with coronary artery disease. The patients underwent clinical and biochemical evaluations.
Results Renal artery stenosis was diagnosed in 29 patients (10.3% of the studied group). Patients with renal artery stenosis were characterized by higher plasma concentrations: creatinine (142.0 ± 59.2 mg% vs 111.0 ± 28.1 mg%, p < 0.001), fibrinogen (399.9 ± 113.9 mg% vs 352.2 ± 103.8 mg%, p < 0.05) and homocysteine (14.1 ± 5.4 μmol/l vs 11.9 ± 4.5 μmol/l, p < 0.05) as compared to patients without renal artery stenosis. Multi-vessel disease was more frequent among patients with renal artery stenosis (72.4% vs 51.4%, p < 0.05).
Conclusions Renal artery stenosis was diagnosed in 10.3% of patients with essential hypertension and coronary artery disease. Atherosclerotic lesions in coronary arteries, especially multi-vessel disease, may indicate increased risk of coexisting renal artery stenosis. Our results indicate that fibrinogen and homocysteine, established atherosclerotic risk factors, may play a role in the development of renal artery stenosis.