Efficacy of percutaneous renal revascularization in resistant hypertension patients

Abstract

Background: Renovascular hypertension is one of the most common potentially curable types of secondary hypertension. Medical therapy alone does not inhibit the progressive loss of renal function. The aim of the present study was to evaluate the efficacy of percutaneous renal revascularization in resistant hypertension patients. Methods: Forty-two patients aged ≥ 45 years with resistant hypertension having renal artery stenosis (>50% luminal narrowing assessed by quantitative renal angiography) undergoing percutaneous transluminal renal angioplasty (PTRA) were included in the study. The primary outcome measures were a response of blood pressure (BP) and the requirement of the number of hypertensive drugs, whereas the secondary outcome measure was to study the correlation of renal vein renin levels (RVRLs) with postrenal angioplasty BP response. Chi-square/Fisher's exact test and unpaired t-test were used to compare qualitative and quantitative variables, respectively. A paired t-test was used for intragroup comparison. Results: The mean systolic BP at 6-month follow-up (159.5 mmHg) was significantly less as compared to baseline (181.3 mmHg) (P = 0.0001). The mean diastolic BP at 6-month follow-up (94.4 mmHg) was significantly less as compared to baseline (106.5 mmHg) (P = 0.0001). The mean number of antihypertensive drugs used at the baseline and 6-month follow-up was 3.4 and 1.8, respectively, which was statistically significant (P = 0.001). There was no significant correlation of RVRL with postrenal angioplasty BP response. Conclusions: In patients with resistant hypertension, PTRA improved BP control and reduced the requirement of antihypertensive drugs.

Keywords

• antihypertensive drugs
• percutaneous transluminal renal angioplasty
• renal vein renin levels
• resistant hypertension