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

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• 作者：Patricia Van der Niepen ; Patrick Rossignol…
• 关键词：Resistant hypertension ; Renal artery stenosis ; Angioplasty and stenting ; Blood pressure
• 刊名：Current Hypertension Reports
• 出版年：2017
• 出版时间：January 2017
• 年：2017
• 卷：19
• 期：1
• 全文大小：
• 刊物主题：Internal Medicine; Cardiology; Metabolic Diseases; Nephrology; Primary Care Medicine; General Practice / Family Medicine;
• 出版者：Springer US
• ISSN：1534-3111
• 卷排序：19

文摘

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.