COMPARISON OF TARGET ORGAN DAMAGE IN RENOVASCULAR AND ESSENTIAL-HYPERTENSION

In many reports, the prevalence of target organ damage in renovascular hypertension (RVH) appears to be higher than in essential hypertensio n (EH). Since in most studies the renal artery stenosis is part of a d iffuse atherosclerotic disease, it is not known whether these complica tions are due to RVH itself or to the vascular disease. We have undert aken a case control study of 92 patients divided into two groups (46 i n each), one with RVH and the other with EH and abdominal aortic aneur ysm, with a comparable degree of diffuse atherosclerotic vascular dise ase. The vascular state of the extracranial carotid arteries and abdom inal and inferior limb districts was investigated with angiography and sonography. The prevalence of left ventricular hypertrophy (LVH) and ischemic heart disease (IHD) were assessed by electrocardiography. Ser um creatinine and urinary protein excretion were employed in the renal evaluation. While the analysis of the results confirmed an even diffu sion of atherosclerotic vascular disease between the two groups, a sig nificant difference was found in the prevalence of heart and renal dam age. LVH was present in 32.6% of RVH patients versus 10.8% in EH (P = .02). Serum creatinine > 1.4 mg/dL was found in 50% of RVH and in 23.9 % of EH, (P = .01). The prevalence of proteinuria in RVH was also high er although not reaching the statistical significance. The results sug gest that, in patients with comparable degrees of atherosclerotic vasc ular disease, RVH is responsible for the higher prevalence of target o rgan damage in this condition compared to those with EH.