Blood pressure response to dynamic exercise in adolescents before and after percutaneous transluminal renal artery angioplasty.
The blood pressure response to maximal bicycle exercise was studied using the James protocol in two adolescents with renal artery stenosis before and after percutaneous transluminal renal artery angioplasty. Prior to angioplasty, one patient (pt A) had persistent and one patient (pt B) had labile elevation of the resting blood pressure above the 95th percentile for age; both patients had elevated systolic blood pressure at maximal exercise (pt A: 215 mm Hg; James expected 170 +/- 20; pt B: 228 mm Hg; James expected 156 +/- 15). Following angioplasty, both patients had resting blood pressures below the 95th percentile for age; patient A had improved systolic pressure at maximal exercise (195 mm Hg) while patient B had persistent elevation in the exercise systolic blood pressure (215 mm Hg). Angiography confirmed the presence of residual/recurrent renal artery stenosis in patient B. We conclude that measurement of blood pressure during exercise may reveal residual abnormalities not apparent at rest and thus may be useful in assessing the result of renal artery angioplasty in children with renal artery stenosis.
D000293:Adolescent; D000800:Angioplasty, Balloon; D001794:Blood Pressure; D005080:Exercise Test; D005260:Female; D006801:Humans; D008297:Male; D012078:Renal Artery Obstruction / Q000503:physiopathology / Q000628:therapy*