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In high risk hypertensive subjects with incidental and unilateral renal artery stenosis percutaneous revascularization with stent improves blood pressure control but not glomerular filtration rate . AIM In high-risk hypertensive subjects ( HTs ) with incidental unilateral renal artery stenosis ( RAS ) , the effectiveness of percutaneous revascularization with stent ( PR-STENT ) on blood pressure ( BP ) and glomerular filtration rate ( GFR ) is not established . METHODS Eighteen HTs aged 65.7 ± 9.2 years with angiographically diagnosed unilateral RAS ( ≥ 60 % ) were randomized to receive PR-STENT ( N=9 ) or to NO-STENT ( N=9 ) . BP ( mercury sphygmomanometer ) and GFR ( 99mTc-DTPA clearances during renal scintigraphy ) were evaluated yearly for three years . Echo-Doppler of renal arteries was performed to verify the anatomic patency and flow velocities of the reperfused artery . Analysis of variance compared BP and GFR values changes from baseline to the follow-up ; differences for continuous variables were evaluated between groups with the Tukey 's post hoc test after adjustment for age , change of BP between baseline and at the follow-up , GFR and body mass index ( BMI ) . RESULTS Baseline systolic BP and GFR values were not different between groups . The significantly greater GFR increase observed in PR-STENT than in NO-STENT at univariate analysis at the end of follow-up ( 62.5 ± 19.2 vs. 42.24 ± 17.6 , P < 0.02 ) disappeared after adjustment for confounding factors . However , systolic BP remained significantly lower in PR-STENT than in NO-STENT ( 140.1 ± 4.6 vs. 170.0 ± 8.3 , P < 0.0001 ) also after adjustment for age , GFR and BMI . CONCLUSION PR-STENT reduces systolic BP without improving GFR . Due to the strong association between high BP and renal damage , this study raises the question on whether PR-STENT should be performed in all HTs with unilateral and incidental RAS .
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Intervention_Surgical
percutaneous revascularization with stent ( PR-STENT )
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Outcome_Physical
blood pressure control
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Outcome_Physical
glomerular filtration rate
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Outcome_Physical
blood pressure
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Outcome_Physical
glomerular filtration rate ( GFR )
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Participant_Condition
high risk hypertensive
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Participant_Condition
incidental and unilateral renal artery stenosis percutaneous revascularization
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Participant_Condition
high-risk hypertensive
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Participant_Condition
incidental unilateral renal artery stenosis ( RAS )