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Incidence of renal artery stenosis in hypertensive patients with ischemic heart disease that underwent simultaneous coronary and renal artery catheterization
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Abstract
Material and methods. The study was carried out in the Department of Hypertension, Angiology and Internal Diseases, Poznan University of Medical Sciences, in 162 patients with arterial hypertension. Patients were recruited among those referred to the hospital for elective coronarography with risk factors of renovascular hypertension. In addition to simultaneous coronarary and renal angiography, among other office and 24-hour automated blood pressure measurements (ABPM), plasma renin activity, C-reactive protein, kidney function were determined.
Results. In the study group, the prevalence of RAS and significant RAS ≥ 50% was respectively 28.4% and 11.1%. Unilateral significant stenosis was 8.6%, and was 3.5 times more frequent than bilateral RAS (2.4%). When comparing patients with and without RAS (RAS+ vs. RAS–), group RAS+ was older and had lower glomelular filtration rate. Group RAS+ had also higher blood pressure: office diastolic (95.4 ± 15.3 vs. 89.8 ± 1.,7; p < 0.05) and in ABPM mean 24-hour systolic (132.1 ± 16.8 vs. 125.7 ± 14.1; p < 0.05) mean both systolic and diastolic at night (128.7/72.8 ± 20.5/10.5 vs. 116.4/67.3 ± 15.2/9.6 mm Hg; p < 0.01). Moreover the night systolic blood pressure fall was lower (FALLSBP) (3.6 ± 11.2% vs. 9.9 ± 7.3%; p < 0.01), as well as diastolic (FALLDBP) (5.8 ± 12.3% vs. 11.6 ± 8.9%; p < 0.01). The were no significant differences in biochemical parameters, office and automated (ABPM) blood pressure measurements between patients with low-grade (< 50%) and high-grade (> 50%) RAS.
Conclusions
1. The prevalence of renal artery stenosis (RAS) in hypertensive patients with suspicion of coronary artery disease and additional risk factors of RAS referred for elective coronarography is high and justifies simultaneous angiography of renal arteries.
2. Patients with renal artery stenosis were older, were characterized by significantly lower GFR, higher blood pressure during the night and lower pressure drop in the night when compared to patients without renal artery stenosis.
3. Among patients with renal artery stenosis there were no significant differences in biochemical and hemodynamic parameters in relation relation to severity of renal artery stenosis.
Abstract
Material and methods. The study was carried out in the Department of Hypertension, Angiology and Internal Diseases, Poznan University of Medical Sciences, in 162 patients with arterial hypertension. Patients were recruited among those referred to the hospital for elective coronarography with risk factors of renovascular hypertension. In addition to simultaneous coronarary and renal angiography, among other office and 24-hour automated blood pressure measurements (ABPM), plasma renin activity, C-reactive protein, kidney function were determined.
Results. In the study group, the prevalence of RAS and significant RAS ≥ 50% was respectively 28.4% and 11.1%. Unilateral significant stenosis was 8.6%, and was 3.5 times more frequent than bilateral RAS (2.4%). When comparing patients with and without RAS (RAS+ vs. RAS–), group RAS+ was older and had lower glomelular filtration rate. Group RAS+ had also higher blood pressure: office diastolic (95.4 ± 15.3 vs. 89.8 ± 1.,7; p < 0.05) and in ABPM mean 24-hour systolic (132.1 ± 16.8 vs. 125.7 ± 14.1; p < 0.05) mean both systolic and diastolic at night (128.7/72.8 ± 20.5/10.5 vs. 116.4/67.3 ± 15.2/9.6 mm Hg; p < 0.01). Moreover the night systolic blood pressure fall was lower (FALLSBP) (3.6 ± 11.2% vs. 9.9 ± 7.3%; p < 0.01), as well as diastolic (FALLDBP) (5.8 ± 12.3% vs. 11.6 ± 8.9%; p < 0.01). The were no significant differences in biochemical parameters, office and automated (ABPM) blood pressure measurements between patients with low-grade (< 50%) and high-grade (> 50%) RAS.
Conclusions
1. The prevalence of renal artery stenosis (RAS) in hypertensive patients with suspicion of coronary artery disease and additional risk factors of RAS referred for elective coronarography is high and justifies simultaneous angiography of renal arteries.
2. Patients with renal artery stenosis were older, were characterized by significantly lower GFR, higher blood pressure during the night and lower pressure drop in the night when compared to patients without renal artery stenosis.
3. Among patients with renal artery stenosis there were no significant differences in biochemical and hemodynamic parameters in relation relation to severity of renal artery stenosis.
Keywords
arterial hypertension, renal artery stenosis, renovascular hypertension, ABPM, coronary artery disease
Title
Incidence of renal artery stenosis in hypertensive patients with ischemic heart disease that underwent simultaneous coronary and renal artery catheterization
Journal
Issue
Article type
Original paper
Pages
27-36
Published online
2014-09-19
Page views
561
Article views/downloads
1086
Bibliographic record
Nadciśnienie tętnicze 2014;18(1):27-36.
Keywords
arterial hypertension
renal artery stenosis
renovascular hypertension
ABPM
coronary artery disease
Authors
Łukasz Stryczyński
Anna Posadzy-Małaczyńska