Response of blood pressure after percutaneous transluminal renal artery angioplasty and stenting

Table 1 Baseline characteristics of study population: Clinical, laboratory and imaging data n (%)

Variables	n = 86
Male gender	67 (77.9)
Age (yr)	55.87 ± 11.85
Background diseases
Stage-1 (malignant) hypertension	14 (16.3)
Stage-2 hypertension	65 (75.6)
Diabetes mellitus	34 (39.5)
Smoking	61 (70.9)
Clinical features of left ventricular dysfunction	23 (26.7)
Left ventricular hypertrophy	29 (33.7)
Coronary artery disease	72 (83.7)
Blood pressure
Systolic (mmHg)	170.15 ± 20.10
Diastolic (mmHg)	98.38 ± 10.55
Antihypertensive drugs (n)	3.07 ± 0.69
Indication criteria
Hypertension resistant to standard medication	71 (82.6)
Renal bruit	53 (61.6)
Serum creatinine (mg/dL)	20 (23.3)
Stenosis
Bilateral	23 (26.7)
Coronary angiography
Single vessel disease	25 (29.1)
Double vessel disease	14 (16.3)
Triple vessel disease	28 (32.6)
Normal vessel	19 (22.1)

Values are presented as percentage (%) and mean ± SD.

Table 2 Blood pressure, antihypertensive medication, serum creatinine and glomerular filtration rate initial vs follow-up measurements

Time of follow-up	mean ± SD	P value
Systolic blood pressure (mmHg)	170.15 ± 20.10	< 0.0001
Baseline
1 mo	146.60 ± 17.32
6 mo	144.23 ± 18.19
Diastolic blood pressure (mmHg)	98.38 ± 10.55	< 0.0001
Baseline
1 mo	89.88 ± 9.22
6 mo	88.26 ± 9.79
Antihypertensive drugs (n)	3.07 ± 0.69	< 0.0001
Baseline
1 mo	2.37 ± 0.84
6 mo	2.25 ± 0.94
Serum creatinine (mg/dL)	1.21 ± 0.66	0.964
Baseline
48 h	1.29 ± 0.88
1 mo	1.33 ± 1.27
6 mo	1.21 ± 0.79
GFR estimation (mL/min)	65.71 ± 25.20	0.546
Baseline
6 mo	66.68 ± 25.03

Values are presented as mean ± SD, P value compares baseline to 6 mo. GFR: Glomerular filtration rate.

Table 3 Levels of sIL-2R, alanine aminotransferase, and hepatitis B virus DNA in the sera of patients with chronic HBV infection (mean ± SD)

Group1	n	mean ± SD	P value
Age (yr)			0.51
A	26	56.81 ± 13.87
B	49	54.80 ± 11.55
Initial systolic BP (mmHg)			0.01
A	26	179.31 ± 20.32
B	49	166.00 ± 18.76
Initial diastolic BP (mmHg)			0.04
A	26	101.92 ± 10.90
B	49	96.79 ± 10.14
Initial mean BP (mmHg)			0.01
A	26	141.00 ± 17.73
B	49	129.00 ± 16.76
No. of medications			0.01
A	26	3.26 ± 0.77
B	49	2.87 ± 0.57
Creatinine (mg/dL)			0.07
A	26	1.38 ± 0.48
B	49	1.11 ± 0.66
Diameter of stent			0.23
A	26	5.76 ± 0.94
B	49	6.05 ± 0.98
Percent of renal artery stenosis (RAS)			0.05
A	26	87.65 ± 7.71
B	49	83.79 ± 8.40
GFR (mL/min)			0.01
A	26	54.03 ± 24.22
B	49	72.97 ± 25.43
Duration of HT (yr)			0.55
A	26	4.00 ± 3.96
B	49	3.40 ± 3.32

Values are presented as mean ± SD.

¹Group A: Patients who did not show blood pressure reduction after percutaneous transluminal renal artery (PTRA) (26 patients); group B: Patients who showed blood pressure reduction after PTRA (49 patients). HT: Hormone Therapy; BP: Blood pressure; GFR: Glomerular filtration rate.

Table 4 Clinical features of resistant hypertensive group: Responsive vs unresponsive to percutaneous transluminal renal artery n (%)

		Group A	Group B	P value
		n = 26	n = 49
	Male gender	24 (92.3)	33 (67.3)	0.016
	Smoker	22 (84.6)	33 (67.4)	0.1
	Ischemic heart disease	21 (80.8)	35 (71.4)	0.376
	Diabetes mellitus	8 (30.8)	19 (38.8)	0.49
	C/f of LVF	5 (19.2)	11 (22.4)	0.746
	Smoking	22 (84.6)	33 (67.4)	0.1
	Renal bruit	20 (76.9)	29 (59.2)	0.124
	Refractory HT	23 (88.5)	37 (75.5)	0.182
	LVH	14 (53.9)	14 (28.6)	0.031
	LAD	19 (73.1)	34 (69.4)	0.733
	TVD	12 (46.2)	13 (26.5)	0.08
Renal artery stenosis	Unilateral RAS	15 (57.7)	40 (81.6)	0.026
(unilat vs bilat)	Bilateral RAS	11 (42.3)	9 (18.4)
LMCA disease	Absent	23 (88.5)	47 (95.9)	0.218
	Present	3 (11.5)	2 (4.1)

Group A: Patients who did not show blood pressure reduction after percutaneous transluminal renal artery (PTRA) (26 patients); and group B: Patients who showed blood pressure reduction after PTRA (49 patients). HT: Hormone therapy; LVH: Left ventricular hypertrophy; TVD: Triple vessel disease; LAD: Left anterior descending; LVF: Left ventricular function; RAS: Renal artery stenosis; LMCA: Left main coronary artery.

Table 5 Multivariate analysis: The independent predictors for poor blood pressure response after percutaneous transluminal renal artery

Variables	UnivariateP value	Multivariate analysis			95%CI
		P value	β	Expβ
Male sex	0.02	0.046	1.797	6.032	1.028–35.380
High mean SBP	0.01	NS
High mean DBP	0.05	NS
High mean BP	0.09	0.013	-0.044	0.957	0.925–0.991
Low GFR (< 60 mL/min)	0.01	0.015	1.377	3.965	1.308–12.020
LVH	0.03	NS
Drugs (n)	0.01	NS
Bilateral vs unilateral RAS	0.02	NS
Percent of stenosis	0.06	NS
Presence of TVD	0.09	NS
Constant			2.365	10.65

TVD: Triple vessel disease; BP: Blood pressure; RAS: Renal artery stenosis; GFR: Glomerular filtration rate; LVH: Left ventricular hypertrophy; SBP: Systolic blood pressure; DBP: Diastolic blood pressure; NS: Not significant.