Resistant Hypertension and Atherosclerotic Renal Artery Stenosis Effects of Angioplasty on Ambulatory Blood Pressure. A Retrospective Uncontrolled Single-Center Study
Resistant Hypertension and Atherosclerotic Renal Artery Stenosis Effects of Angioplasty on Ambulatory Blood Pressure. A Retrospective Uncontrolled Single-Center Study
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DOI：
10.1161/hypertensionaha.119.13393
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发表时间：
2019-12-01
期刊：
影响因子：
8.3
通讯作者：
Amar, Laurence
中科院分区：
文献类型：
--
作者：
Courand, Pierre-Yves;Dinic, Miriana;Amar, Laurence
由于大多数试验将这些患者排除在外，肾动脉血管成形术对真正的难治性高血压和动脉粥样硬化性肾动脉狭窄患者血压的影响尚未得到充分研究。在这项研究中，我们评估了肾血管成形术对这一亚组患者日间动态血压（dABP）的益处。回顾性分析我院高血压科2000年至2016年的病历。72例患者被诊断为难治性高血压（尽管使用了至少3种降压药物，包括利尿剂，但dABP>135或85 mm Hg）和接受血管成形术治疗的动脉粥样硬化性肾动脉狭窄。动脉粥样硬化性肾动脉狭窄为单侧 57 例，双侧 15 例。患者的平均年龄为 67.8 +/- 11.2 岁；尽管进行了 4.0 +/- 1.0 次抗高血压治疗，dABP 仍为 157 +/- 16/82 +/- 10 mm Hg；估计肾小球滤过率为 52 (41-63) mL/min。肾血管成形术后，dABPM 降低 14.0 +/- 17.3/6.4 +/- 8.7 mm Hg (P
The effect of renal artery angioplasty on blood pressure in patients with true resistant hypertension and atherosclerotic renal artery stenosis has not been fully investigated due to the exclusion of these patients from most trials. In this study, we assessed the benefits of renal angioplasty on daytime ambulatory blood pressure (dABP) in this subgroup of patients. Medical records of our hypertension department were retrospectively analyzed from 2000 to 2016. Seventy-two patients were identified with resistant hypertension (dABP >135 or 85 mm Hg despite at least 3 antihypertensive drugs, including a diuretic) and atherosclerotic renal artery stenosis treated by angioplasty. Atherosclerotic renal artery stenosis was unilateral in 57 patients and bilateral in 15 patients. The mean age of the patients was 67.8 +/- 11.2 years; dABP was 157 +/- 16/82 +/- 10 mm Hg despite 4.0 +/- 1.0 antihypertensive treatments; estimated glomerular filtration rate was 52 (41-63) mL/min. After renal angioplasty, dABPM decreased by 14.0 +/- 17.3/6.4 +/- 8.7 mm Hg (P