بررسي نتايج آنژيوپلاستي شريان كليه در بيماران مبتلا به فشار خون بالا: يك مطالعه ي مداخله اي

The Outcomes of Percutaneous Transluminal Renal Artery Angioplasty in Hypertensive Patients: An Interventional Study

Background: Renal artery stenosis (RAS) is one of the main causes of secondary hypertension and the most preventable cause of RAS is atherosclerosis. Recently, percutaneous transluminal renal artery angioplasty (PTRA) has become the treatment of choice for RAS. We assessed the outcome of PTRA in a sample of patients referred to heart clinics in Isfahan University of Medical Sciences. Methods: Thirty two patients with RAS and persistent hypertension were selected and underwent of percutaneous transluminal renal artery angioplasty. Then, they were followed for 4 weeks by a cardiologist. The main outcomes were blood pressure, serum creatinine, cardiac functional state and chest pain. The Repeated Measure of ANOVA and Freidman test were used for statistical comparisons via SPSS14 software. Findings: The mean of systolic blood pressure decreased from 199.4 to 142.2 mmHg during 4 weeks follow-up (P < 0.0001); the diastolic blood pressure decreased from 114 to 89.2 mmHg too (P < 0.0001). The cardiac functional state increased and chest pain decreased significantly during 4 weeks; but the serum creatinine level showed no significant decrease. Conclusion: PTRA is a useful method for treatment of hypertension in patients with RAS. It decreases the Renin-Angiotensin-Aldostron pathway and declines neurohormonl activities. Thus these changes decrease blood pressure level and cardiovascular morbidity and mortality. It improves renal function, too. By this procedure, the need for antihypertensive drugs will decrease and it has economic benefits for patients too.