Clinical Effect Analysis Of Interventional Treatment Of Hypertension Associated With Renal Artery Stenosis

Objective:The purpose of our study was to evaluate and summarize the clinical effect of percutaneous transluminal angioplasty in the treatment of hypertension associated with renal artery stenosis.Methods:From January 2016 to June 2018,72 patients with hypertension who had renal artery stenosis confirmed by renal artery angiography in Tongji Hospital affiliated to Tongji Medical College,Huazhong University of Science and Technology,were included in the study.According to whether the patients were treated with interventional therapy,they were divided into two groups(drug treatment group and interventional treatment group).The baseline data of the two groups were collected by electronic medical record system.Follow-up the patients'blood pressure,the type of antihypertensive drugs,renal function,and then evaluate the effect of interventional therapy on blood pressure and renal function in patients with hypertension associated with renal artery stenosis.Results:The systolic blood pressure in the drug-treated group decreased from 156±16 to142±12mmHg(P<0.05),the diastolic blood pressure did not change significantly,the type of antihypertensive drugs increased from 1.54±0.96 to 2.29±1.12(P<0.05),and the benefit rate was 28.5%.There was no significant change in serum creatinine or eGFR,with a benefit rate of 89%.In the interventional treatment group,the systolic blood pressure significantly decreased(from 157±25 to 144±19 mm Hg;P<0.01),but there was no significant change in the diastolic blood pressure,the type of antihypertensive drugs was slightly lower than that before surgery(from 2.23±1.2 to 1.84±1.4),but there was no statistical difference(P>0.05),and the benefit rate was 40.90%.There was no significant change in serum creatinine or eGFR,with a benefit rate of 94%.In the interventional group,systolic and diastolic blood pressures were significantly reduced in patients with preoperative eGFR?60 ml/min/1.73 m~2(from 162±23 to 144±21 mmHg,from 93±14to 86±13 mmHg;P=0.001),and no significant changes in the type of antihypertensive drugs or serum creatinine.But there were no significant changes in systolic and diastolic blood pressure in patients with preoperative eGFR<60 ml/min/1.73 m~2,The type of antihypertensive drugs increased slightly compared(from 1.84±1.4 to 2.23±1.2)and serum creatinine decreased slightly(from 150.3±40.2 to 132.4±43.3?mol/L),but there was no statistical difference(P>0.05).Conclusion:Percutaneous transluminal angioplasty reduces the patients'systolic blood pressure without increasing the type of antihypertensive medication,and stabilizes kidney function.In particular,for the patients with better baseline renal function(eGFR?60ml/min/1.73 m~2),percutaneous revascularization has a greater benefit in controlling blood pressure.