B. Symonides et al., Effects of the correction of renal artery stenosis on blood pressure, renal function and left ventricular morphology, BLOOD PRESS, 8(3), 1999, pp. 141-150
The aim of this study was to evaluate the effect of renal artery stenosis (
RAS) correction in hypertensive patients on 24 h SEP, 24 h DBP, creatinine
clearance (GFR), urinary albumin excretion (UAE) and LV morphology and mass
(LVMI). A total of 61 hypertensive patients With RAS undergoing PTRA and/o
r surgical treatment entered the prospective study. The final analysis was
done in 44 patients (age range 45.8 +/- 16.2 years) with RAS (atheroscleros
is (ASC) 31 patients, :fibromuscular dysplasia (FMD) 12 patients, arteritis
1 patient) who underwent PTRA (34 patients) or surgical treatment (10 pati
ents) and presented no Doppler signs of restenosis (or a new stenosis) duri
ng 1-year observation. The pre-interventional assessment repeated after 6 a
nd 12 months included ABPM, GFR, UAE and echocardiography. The results were
analysed in the combined group (CG) and in according aetiology. 24 h SEP a
nd 24 h DBP decreased in all groups 6 months post-intervention and did not
change further. Cure of HT was observed in 35% and 29% of ASC patients at 6
and 12 months respectively; and in 58% of FMD patients. Failure rate at 12
months was 48% in ASC against 25% in FMD. The mean GFR in CG was higher 12
months after intervention. The increase in GFR was noted in 45% of patient
s, the decrease in 25% of patients at 12 months. Normal values of UAE were
found in 71% of patients, pre- and post-intervention alike. Mean LVMI and n
umber of patients with LVH,in CG decreased already during the initial 6 mon
ths post-intervention and did not change further. In conclusion, correction
of RAS leads to cure of or improved control of hypertension in the majorit
y of the patients with FMD, but in the ASC group in about half of cases no
BP cure or improvement was seen. The renal function was improved or stable
in two-thirds of patients after revascularization. Successful renal revascu
larization was followed by regression of LVH, which was evident within 6 mo
nths post-intervention.