[Fibromuscular renovascular hypertension: comparison of surgery, transluminal dilatation and drug therapy].
82 patients with fibromuscular renovascular hypertension have been studied. 33 patients were treated surgically (group I), 28 underwent transluminal dilation (group II) and 21 received drug treatment (group III). After a follow-up period of 2.5 (0.1-7) years, blood pressure in group I had decreased from 207 +/- 27/128 +/- 17 mm Hg to 135 +/- 15/85 +/- 9 mm Hg after surgery (p less than 0.001). 1.3 (0.1-4) years after dilation, group II showed a decrease of blood pressure from 174 +/- 25/107 +/- 13 mm Hg to 143 +/- 26/88 +/- 12 mm Hg (p less than 0.001). Blood pressure in group III decreased under drug therapy from 203 +/- 41/122 +/- 16 mm Hg to 146 +/- 19/92 +/- 8 mm Hg (p less than 0.001). 52% of the surgical patients and 50% of the dilated patients were cured, whereas 45% and 39% respectively were improved and 3% and 11% respectively did not improve. In group III, under antihypertensive drug therapy, blood pressure normalized in 62% of the patients, 33% showed better values and 5% did not improve. The complication rate was 11% in group I and 3.3% in group II. In two patients dilation was technically impossible. In group III one patient (4.8%) showed a massive but reversible increase of serum creatinine under captopril. In 70% of all patients the renal vein renin ratio was greater than or equal to 1.5. However, this ratio was unreliable as a parameter to predict the blood pressure decrease with curative methods. It is concluded from the above that all three methods offered good to very good results.(ABSTRACT TRUNCATED AT 250 WORDS)
Lüscher
T F
TF
Greminger
P
P
Kuhlmann
U
U
Largiadèr
F
F
Schneider
E
E
Pouliadis
G
G
Siegenthaler
W
W
Vetter
W
W
D000328:Adult; D000800:Angioplasty, Balloon; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D005352:Fibromuscular Dysplasia / Q000150:complications; D006801:Humans; D006978:Hypertension, Renovascular / Q000188:drug therapy / Q000209:etiology / Q000601:surgery / Q000628:therapy*; D008875:Middle Aged
D000959:Antihypertensive Agents
Fibromuskuläre renovaskuläre Hypertonie: Vergleich von Operation, transluminaler Dilatation und medikamentöser Therapie.