CLINICAL TRIAL: STENTING WITH ANTI-HYPERTENSIVE MEDICAL THERAPY, COMPARED TO MED

这个子项目是众多研究子项目之一

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. This study is designed to compare the safety and effectiveness of treating renal artery stenosis with the use of an investigational device, the PALMAZ GENESIS Stent. There likely exists a logical progression wherein renal ischemia, due to RAS, leads to clinical events such as ischemia, neuroendocrine activation, hypertension, and renal insufficiency. These factors result in pathophysiologic alterations including acceleration of atherosclerosis, enhanced thrombosis, further renal dysfunction and development of left ventricular hypertrophy, amongst others. These in turn lead to clinical events including CHF, myocardial infarction (MI), stroke, progressive renal insufficiency, and ultimately death. At the heart of this study is the fundamental question of whether anti-hypertensive pharmacologic therapy, directed at 1 or several mechanisms, is sufficient to interrupt this process or whether revascularization is required. This study will also look at critical steps in the pathway leading to clinical events including BP control, renal function, and the anatomic stenosis to understand whether these relationships exist. Thus, beyond answering an important clinical question, the study will enhance our understanding of the disease. To address the health policy and quality of care implications of our findings, this study will carefully examine the impact of these alternative treatments on quality of life and cost-effectiveness of care.