Efficacy of 24-Hour Blood Pressure Monitoring in Evaluating Response to Percutaneous Transluminal Renal Angioplasty

Background:Percutaneous transluminal renal angioplasty (PTRA) improves patency in atherosclerotic renal artery stenosis (ARAS), but improvement in clinic blood pressure (BP) is seen in only 20–40% of patients who undergo PTRA. This study investigated the effects of PTRA on BP lowering, assessed on 2...

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Bibliographic Details
Published in:Circulation Journal 2016/08/25, Vol.80(9), pp.1922-1930
Main Authors: Jujo, Kentaro, Saito, Katsumi, Ishida, Issei, Furuki, Yuho, Ouchi, Taisuke, Kim, Ahsung, Suzuki, Yuki, Sekiguchi, Haruki, Yamaguchi, Junichi, Ogawa, Hiroshi, Hagiwara, Nobuhisa
Format: Article
Language:English
Subjects:
Aged
Angioplasty
Blood Pressure
Blood Pressure Monitoring, Ambulatory
Coronary Angiography
Female
Humans
Hypertension
Male
Peripheral artery disease
Renal
Renal Artery Obstruction - diagnostic imaging
Renal Artery Obstruction - physiopathology
Renal Artery Obstruction - surgery
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Summary:Background:Percutaneous transluminal renal angioplasty (PTRA) improves patency in atherosclerotic renal artery stenosis (ARAS), but improvement in clinic blood pressure (BP) is seen in only 20–40% of patients who undergo PTRA. This study investigated the effects of PTRA on BP lowering, assessed on 24-h ambulatory BP monitoring (ABPM), and identified preoperative features predictive of satisfactory BP improvement after PTRA.Methods and Results:Of 1,753 consecutive patients undergoing coronary angiography, 31 patients with angiographically significant ARAS and translesional pressure gradient (TLPG) >20 mmHg underwent PTRA. ABPM was performed before, at 1 month and at 1 year after PTRA; patients with average systolic ABPM-BP decrease >10 mmHg at 1 month from baseline were categorized as responders. There was no obvious relationship between clinic BP and ABPM-BP at baseline. ABPM-BP was significantly higher in responders at baseline (SBP: 148 vs. 126 mmHg, P
ISSN:1346-9843
1347-4820
DOI:10.1253/circj.CJ-16-0347