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Predictors of long-term beneficial effects on blood pressure after percutaneous transluminal renal angioplasty in atherosclerotic renal artery stenosis.

Alhadad, Alaa LU ; Mattiasson, Ingrid LU ; Ivancev, Krassi LU ; Lindblad, Bengt LU and Gottsäter, Anders LU (2009) In International Angiology 28(2). p.106-112
Abstract
AIM: This retrospective study evaluated long-term effects of percutaneous transluminal renal angioplasty (PTRA) in atherosclerotic renal artery stenosis (ARAS), and predictors of benefit on blood pressure (BP). METHODS: During 1997-2003, 234 patients (age 69+/-11 years, 138 [59%] males) underwent PTRA for ARAS at Malmö Vascular Centre. Cure was defined as diastolic (D)BP<90 mmHg and systolic (S)BP <140 mmHg off antihypertensive medication. Improvement was defined as DBP <90 mmHg and/or SBP <140 mmHg on the same or reduced number of medications, or reduction in DBP of 15 mmHg with the same or reduced number of medications. Benefit was defined as cure or improvement. RESULTS: After PTRA, SBP and DBP decreased (P<0.001), and... (More)
AIM: This retrospective study evaluated long-term effects of percutaneous transluminal renal angioplasty (PTRA) in atherosclerotic renal artery stenosis (ARAS), and predictors of benefit on blood pressure (BP). METHODS: During 1997-2003, 234 patients (age 69+/-11 years, 138 [59%] males) underwent PTRA for ARAS at Malmö Vascular Centre. Cure was defined as diastolic (D)BP<90 mmHg and systolic (S)BP <140 mmHg off antihypertensive medication. Improvement was defined as DBP <90 mmHg and/or SBP <140 mmHg on the same or reduced number of medications, or reduction in DBP of 15 mmHg with the same or reduced number of medications. Benefit was defined as cure or improvement. RESULTS: After PTRA, SBP and DBP decreased (P<0.001), and remained lower (P<0.001) until last follow-up after 4.1+/-3.3 years. Antihypertensive medication decreased (P<0.001), and remained lower at one month (P<0.001), one year (P<0.01), and last follow-up (P<0.05). Renal function was unchanged until last follow-up, when it deteriorated (P<0.001). Patients showing benefit of PTRA on BP at last follow-up (N.=150 [64%]) used more antihypertensive drugs before PTRA (P=0.012), especially angiotensin converting enzyme inhibitors (ACEi) or angiotensin II receptor blockers (ARBs) (P=0.010), and diuretics (P=0.015). In logistic regression, use of ACEi or ARBs failed to reach significancy (P=0.054). Patients dying during follow up (N.=100 [43%]) showed higher age (P<0.0001) and s-creatinine (P<0.0001), lower glomerular filtration rate (P<0.0001), and higher frequency of diabetes mellitus (P<0.005). In logistic regression only age (P=0.009) and diabetes mellitus (P=0.014) predicted mortality. CONCLUSIONS: We confirmed beneficial effects on BP with PTRA in ARAS. ACEi, ARB and diuretic treatment before PTRA predict favourable long-term BP-response in univariate analysis. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
International Angiology
volume
28
issue
2
pages
106 - 112
publisher
Minerva Medica
external identifiers
  • wos:000267436400004
  • pmid:19367240
  • scopus:67650432940
ISSN
1827-1839
language
English
LU publication?
yes
id
1668ea96-74b3-4a2b-985f-df02daf6090a (old id 1392104)
alternative location
http://www.ncbi.nlm.nih.gov/pubmed/19367240?dopt=Abstract
date added to LUP
2009-05-06 13:49:23
date last changed
2017-01-01 07:30:19
@article{1668ea96-74b3-4a2b-985f-df02daf6090a,
  abstract     = {AIM: This retrospective study evaluated long-term effects of percutaneous transluminal renal angioplasty (PTRA) in atherosclerotic renal artery stenosis (ARAS), and predictors of benefit on blood pressure (BP). METHODS: During 1997-2003, 234 patients (age 69+/-11 years, 138 [59%] males) underwent PTRA for ARAS at Malmö Vascular Centre. Cure was defined as diastolic (D)BP&lt;90 mmHg and systolic (S)BP &lt;140 mmHg off antihypertensive medication. Improvement was defined as DBP &lt;90 mmHg and/or SBP &lt;140 mmHg on the same or reduced number of medications, or reduction in DBP of 15 mmHg with the same or reduced number of medications. Benefit was defined as cure or improvement. RESULTS: After PTRA, SBP and DBP decreased (P&lt;0.001), and remained lower (P&lt;0.001) until last follow-up after 4.1+/-3.3 years. Antihypertensive medication decreased (P&lt;0.001), and remained lower at one month (P&lt;0.001), one year (P&lt;0.01), and last follow-up (P&lt;0.05). Renal function was unchanged until last follow-up, when it deteriorated (P&lt;0.001). Patients showing benefit of PTRA on BP at last follow-up (N.=150 [64%]) used more antihypertensive drugs before PTRA (P=0.012), especially angiotensin converting enzyme inhibitors (ACEi) or angiotensin II receptor blockers (ARBs) (P=0.010), and diuretics (P=0.015). In logistic regression, use of ACEi or ARBs failed to reach significancy (P=0.054). Patients dying during follow up (N.=100 [43%]) showed higher age (P&lt;0.0001) and s-creatinine (P&lt;0.0001), lower glomerular filtration rate (P&lt;0.0001), and higher frequency of diabetes mellitus (P&lt;0.005). In logistic regression only age (P=0.009) and diabetes mellitus (P=0.014) predicted mortality. CONCLUSIONS: We confirmed beneficial effects on BP with PTRA in ARAS. ACEi, ARB and diuretic treatment before PTRA predict favourable long-term BP-response in univariate analysis.},
  author       = {Alhadad, Alaa and Mattiasson, Ingrid and Ivancev, Krassi and Lindblad, Bengt and Gottsäter, Anders},
  issn         = {1827-1839},
  language     = {eng},
  number       = {2},
  pages        = {106--112},
  publisher    = {Minerva Medica},
  series       = {International Angiology},
  title        = {Predictors of long-term beneficial effects on blood pressure after percutaneous transluminal renal angioplasty in atherosclerotic renal artery stenosis.},
  volume       = {28},
  year         = {2009},
}