Renal Artery Stenosis in Patients with Resistant Hypertension: Stent It or Not?

After three large neutral trials in which renal artery revascularization failed to reduce cardiovascular and renal morbidity and mortality, renal artery stenting became a therapeutic taboo. However, this is probably unjustified as these trials have important limitations and excluded patients most li...

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Bibliographic Details
Published in:Current hypertension reports 2017, Vol.19 (1), p.5-5, Article 5
Main Authors: Van der Niepen, Patricia, Rossignol, Patrick, Lengelé, Jean-Philippe, Berra, Elena, Sarafidis, Pantelis, Persu, Alexandre
Format: Article
Language:English
Subjects:
Blood Pressure
Cardiology
Family Medicine
General Practice
Humans
Hypertension
Hypertension - complications
Hypertension - physiopathology
Internal Medicine
Medicine
Medicine & Public Health
Metabolic Diseases
Nephrology
Primary Care Medicine
Renal Artery
Renal Artery Obstruction - complications
Resistant Hypertension (E Pimenta
Section Editor
Stents
Topical Collection on Resistant Hypertension
Treatment Outcome
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Summary:After three large neutral trials in which renal artery revascularization failed to reduce cardiovascular and renal morbidity and mortality, renal artery stenting became a therapeutic taboo. However, this is probably unjustified as these trials have important limitations and excluded patients most likely to benefit from revascularization. In particular, patients with severe hypertension were often excluded and resistant hypertension was either poorly described or not conform to the current definition. Effective pharmacological combination treatment can control blood pressure in most patients with renovascular hypertension. However, it may also induce further renal hypoperfusion and thus accelerate progressive loss of renal tissue. Furthermore, case reports of patients with resistant hypertension showing substantial blood pressure improvement after successful revascularization are published over again. To identify those patients who would definitely respond to renal artery stenting, properly designed randomized clinical trials are definitely needed.
ISSN:1522-6417
1534-3111
DOI:10.1007/s11906-017-0703-8