Prevalence of and risk factors of renal artery stenosis in patients with resistant hypertension

Am J Cardiol. 2014 Feb 15;113(4):687-90. doi: 10.1016/j.amjcard.2013.10.046. Epub 2013 Nov 23.

Abstract

Renal artery stenosis (RAS) is a common cause of secondary hypertension. Renal artery angiography is the gold standard for diagnosing RAS. The aim of this study is to report (1) the prevalence of RAS in patients with resistant hypertension and (2) the association of RAS with peripheral vascular disease (PVD) and diabetes mellitus (DM). We studied 285 consecutive patients (mean age: 72.5 years) with resistant hypertension (systolic blood pressure >140 mm Hg despite administration of at least 3 antihypertensive drugs) who underwent renal artery angiography at Baylor Heart and Vascular Hospital from January 2006 to December 2010. Sixty-nine cases of RAS were identified (incidence: 24.2%). The propensity-adjusted analysis (controlling for clinical and nonclinical risk factors) showed a strong and significant association between RAS and PVD (odds ratio 5.15, 95% confidence interval 2.68 to 9.89, p <0.0001). However, the association between RAS and DM, a previously defined risk factor for RAS, was not significant in this cohort (odds ratio 0.63, 95% confidence interval 0.34 to 1.19, p = 0.16). In conclusion, results from this study define the prevalence of RAS in patients with resistant hypertension. Patients with PVD were found to be 5 times more likely to experience RAS than patients without PVD, whereas DM did not confer any increased risk.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Angiography
  • Cross-Sectional Studies
  • Diabetes Mellitus / diagnostic imaging*
  • Female
  • Humans
  • Hypertension / complications*
  • Hypertension / diagnostic imaging
  • Male
  • Middle Aged
  • Peripheral Vascular Diseases / complications*
  • Peripheral Vascular Diseases / diagnostic imaging
  • Prevalence
  • Propensity Score
  • Renal Artery Obstruction / complications
  • Renal Artery Obstruction / diagnostic imaging
  • Renal Artery Obstruction / epidemiology*
  • Risk Factors