title: Renal artery stenosis in the antiphospholipid (Hughes) syndrome and hypertension.
abstract: BACKGROUND
  Hypertension is common in the antiphospholipid (Hughes) syndrome (APS) and its cause is poorly understood. Anecdotal evidence suggests that renal artery stenosis (RAS) may be a relevant and treatable cause of hypertension.
  
  
  OBJECTIVE
  To investigate the prevalence of RAS in patients with APS and hypertension.
  
  
  METHODS
  Three groups of patients were evaluated: (1) 77 patients with positive antiphospholipid antibodies (aPL) (60 secondary APS, 11 primary APS, and 6 with aPL only) and uncontrolled hypertension who were receiving two or more antihypertensive drugs; (2) 91 patients (</=50 years) attending hypertension clinics;(3) 92 normotensive healthy, potential renal transplant donors. Magnetic resonance renal angiography was used to image the renal arteries in all three groups.
  
  
  RESULTS
  Group 1: 20/77 (26%) patients had evidence of RAS (16 unilateral and 4 bilateral). Sixteen patients (80%) had smooth well defined stenoses in the proximal third of the renal artery. Three further patients had irregular arteries without distinct stenosis. Group 2: 7/91 (8%) hypertensive patients had RAS (chi(2)=10.3, p<0.001 v group 1). Group 3: 3/92 (3%) healthy donors had RAS (chi(2)=18.2, p<0.0001 v group 1).
  
  
  CONCLUSIONS
  A significantly increased prevalence of RAS (26%) was found in patients with APS and hypertension, compared with relatively young (</=50 years) hypertensive controls and healthy potential donors.
authors.affiliation: The Lupus Research Unit, The Rayne Institute, Lambeth Wing, St Thomas' Hospital, London SE1 7EH, UK. shirish.sangle@gstt.sthames.nhs.uk
authors.forename: S R
authors.initials: SR
authors.lastname: Sangle
authors.forename: D P
authors.initials: DP
authors.lastname: D'Cruz
authors.forename: W
authors.initials: W
authors.lastname: Jan
authors.forename: M Y
authors.initials: MY
authors.lastname: Karim
authors.forename: M A
authors.initials: MA
authors.lastname: Khamashta
authors.forename: I C
authors.initials: IC
authors.lastname: Abbs
authors.forename: G R V
authors.initials: GR
authors.lastname: Hughes
mesh_terms: D000328:Adult; D000368:Aged; D016736:Antiphospholipid Syndrome / Q000150:complications* / Q000000981:diagnostic imaging / Q000473:pathology; D016009:Chi-Square Distribution; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications* / Q000000981:diagnostic imaging / Q000473:pathology; D018810:Magnetic Resonance Angiography; D008297:Male; D008875:Middle Aged; D011859:Radiography; D012077:Renal Artery / Q000000981:diagnostic imaging / Q000473:pathology; D012078:Renal Artery Obstruction / Q000150:complications* / Q000175:diagnosis