The Incidence Of Accessory Renal Arteries In Hypertensive Patients And The Impact Of Accessory Renal Arteries In Patients With Essential Hypertension

Objective : Assess the number and pattern of accessory renal arteries(ARA)in hypertensive patients by CT angiography or MR angiography to know the incidence of ARA and then evaluate the impact of ARA in patients with essential hypertension(EH)to find out the cause of the hypertensive patients with ARA and give good evidence of diagnosis and treatment to these patients.Methods:From January 2011 to June 2016,2277 consecutive patients with hypertension admitted to our hospital underwent CT angiography or MR angiography of the renal arteries for assessment of ARA.Then the history and the results of examinations of 1573 EH patients from 2277 hypertensive patients were collected to be retrospectively analysed.Results:Of 2277 hypertensive patients,39.7% showed ARA.There were 40.1% of EH patients with ARA and 38.5% of secondary hypertension(SH)with ARA(p>0.05).The incidence of ARA was significantly greater in males(42.9%)than in females(35.6%)(p<0.05).No statistically significant difference was found between right and left side or unilateral and bilateral side(p>0.05).Of 1573 EH patients,the average daytime diastolic blood pressure of the patients with ARA was significantly higher than those without ARA(p<0.05),whereas the left ventricular ejection fraction of the patients with ARA was significantly lower than those without ARA(p<0.05).The levels of supine plasma aldosterone concentration,supine plasma renin activity(PRA)and standing PRA of the EH patients with bilateral ARA were significantly higher than those with unilateral ARA(p<0.05).Conclusion : We found statistically significant difference in the prevalence of ARA between males and females in hypertensive patients.The blood pressure of the EH patients with ARA was higher than those without ARA.Meanwhile,EH patients with ARA made more difference on target organs than those without ARA did and the EH patients with bilateral ARA had more effect on renin-angiotensin-aldosterone system than those with unilateral ARA did.The findings imply that ARA may raise blood pressure through RAAS and might be a cause of hypertension.