Prevalence of and Risk Factors of Renal Artery Stenosis in Patients With Resistant Hypertension
Abstract
Renal artery stenosis (RAS) is a common cause of secondary hypertension. Renal artery angiography is the gold standard for diagnosing RAS. The aim of this study is to report (1) the prevalence of RAS in patients with resistant hypertension and (2) the association of RAS with peripheral vascular disease (PVD) and diabetes mellitus (DM). We studied 285 consecutive patients (mean age: 72.5 years) with resistant hypertension (systolic blood pressure >140 mm Hg despite administration of at least 3 antihypertensive drugs) who underwent renal artery angiography at Baylor Heart and Vascular Hospital from January 2006 to December 2010. Sixty-nine cases of RAS were identified (incidence: 24.2%). The propensity-adjusted analysis (controlling for clinical and nonclinical risk factors) showed a strong and significant association between RAS and PVD (odds ratio 5.15, 95% confidence interval 2.68 to 9.89, p <0.0001). However, the association between RAS and DM, a previously defined risk factor for RAS, was not significant in this cohort (odds ratio 0.63, 95% confidence interval 0.34 to 1.19, p = 0.16). In conclusion, results from this study define the prevalence of RAS in patients with resistant hypertension. Patients with PVD were found to be 5 times more likely to experience RAS than patients without PVD, whereas DM did not confer any increased risk.
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More recent series indicate that 24% of older subjects (mean age, 71 years) with resistant hypertension have significant renal arterial disease.
“More recent series indicate that 24% of older subjects (mean age, 71 years) with RH have significant renal arterial disease.307”
From Resistant Hypertension: Detection, Evaluation, and Management: A Scientific Statement From the American Heart Association (2018) · cites this paper as [307]
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- Authors
- Benjamin, M. M., Fazel, P., Filardo, G., Choi, J. W., & Stoler, R. C.
- Affiliations
- Baylor University Medical Center (US)
- Baylor Scott & White Health (US)
- Texas A&M Health Science Center (US)
- Corresponding author
- Benjamin, Mina M.
- Venue
- The American Journal of Cardiology
- Publisher
- Elsevier BV
- Published
- 2014-02
- Volume
- 113
- Issue
- 4
- Pages
- 687-690
- ISSN
- 0002-9149 (ISSN-L)
- OpenAlex
- W2027294421
- Cited by
- 51
- References
- 19
- Citations by year
- 2026: 3 · 2025: 1 · 2024: 8 · 2023: 2 · 2022: 3 · 2021: 2 · 2020: 9 · 2019: 5 · 2018: 3 · 2017: 6 · 2016: 3 · 2015: 1 · 2014: 4
- FWCI
- 2.17
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The American Journal of Cardiology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Renal and Vascular Pathologies
- Health Sciences › Medicine › Surgery › Peripheral Artery Disease Management
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Blood Pressure and Hypertension Studies
- Keywords
- renal artery stenosis, resistant hypertension, secondary hypertension, peripheral vascular disease, diabetes mellitus, prevalence, risk factors, renal artery angiography, propensity score matching
- MeSH terms
- Aged, Aged, 80 and over, Angiography, Cross-Sectional Studies, Diabetes Mellitus, Female, Humans, Hypertension, Male, Middle Aged, Renal Artery Obstruction, Risk Factors, Prevalence, Peripheral Vascular Diseases, Propensity Score
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