PREVALENCE OF ANATOMICAL RENAL-ARTERY STE NOSIS IN HYPERTENSIVE PATIENTS WITH PERIPHERAL VASCULAR-DISEASE

Atherosclerosis is a diffuse disease that can affect renal arteries. A n important point for the management of hypertensive patients is the p revalence of anatomical renal stenosis when lower-limb peripheral vasc ular disease coexists with hypertension. From Sept 1, 1987, to Aug 31, 1990, 252 consecutive hypertensive adults with peripheral vascular di sease were referred to our clinic. For each patient a standardised col lection of information was checked and registered with a computerised system. The evaluation included the search for a curable cause of hype rtension, the investigation of cardiovascular risk factors, and a comp lete clinical review. Peripheral vascular disease was confirmed at]eas t by clinical observation, including and ankle/brachial systolic blood pressure ratio of less than 0.90 at rest. In 117 patients (73 males, 44 females, mean age 66), renal arteriography was performed because cl inical history, initial diagnostic work-up, or duplex Doppler examinat ion suggested renal artery stenosis. Finally, 89 anatomical renal arte ry stenoses were detected in 64 patients (54.7%). Stenosis was judged mild (25 to 50%) in 12 patients and severe (> 50%) in 52 patients incl uding 5 occlusions of the renal arteries. Artery stenosis was found bi lateral in 23 patients. Even if none patient without renal arteriograp hy would have an anatomical renal artery stenosis, the prevalence of a natomical renal stenosis in this study would reach 25.4% (64/252). The se results confirm that lower-limb peripheral vascular disease is an e xcellent marker for the presence of anatomical artery renal stenosis i n hypertensive patients.