Early observations of the effect of extracorporeal shockwave lithotripsy on blood pressure: a prospective randomized control clinical trial.
OBJECTIVE
To determine, in a randomized controlled clinical trial, the effect of extracorporeal shock wave lithotripsy (ESWL) on blood pressure.


METHODS
The trial included 228 patients with small (< 15 mm) asymptomatic calyceal stones who were randomised to undergo ESWL (113 patients) or to an untreated (observed) control group (115 patients). Blood pressure was recorded at randomization using a standardized protocol. Patients undergoing ESWL received a mean (SD) of 5281 (3462) shocks over a mean of 1.75 sessions on one of two lithotripters. Patients were then followed annually, assessing blood pressure and changes in medication. Data were analysed on an intention-to-treat basis.


RESULTS
At randomization, 43% of patients in the control group and 53% in the ESWL group were hypertensive. Of the 228 randomized, 200 patients completed at least one annual follow-up, of whom 192 (93 in the control and 99 in the ESWL group) had their blood pressure recorded. The mean follow-up was 2.2 years; 35 (37%) patients in the control and 46 (46%) in the ESWL group were hypertensive (P = 0.19). Seven (7%) patients in the control group and 11 (11%) in the ESWL group were newly diagnosed to be hypertensive (P = 0.35).


CONCLUSIONS
In this randomized controlled clinical trial there was no evidence that ESWL causes changes in blood pressure.
Elves
A W
AW
Stone Management Centre, Department of Urology, Southmead Hospital, Bristol, UK.
Tilling
K
K
Menezes
P
P
Wills
M
M
Rao
P N
PN
Feneley
R C
RC
D000368:Aged; D001794:Blood Pressure / Q000502:physiology*; D015986:Confounding Factors, Epidemiologic; D005500:Follow-Up Studies; D006801:Humans; D006973:Hypertension / Q000209:etiology*; D007669:Kidney Calculi / Q000503:physiopathology / Q000628:therapy*; D008096:Lithotripsy / Q000009:adverse effects*; D008875:Middle Aged; D011446:Prospective Studies