title: Usefulness of wide pulse pressure as a predictor of poor outcome after renal artery angioplasty and stenting.
abstract: Renal artery stenosis is a common cause of secondary hypertension and ischemic nephropathy. Percutaneous angioplasty and stent placement has allowed select patients with renal artery stenosis to use fewer antihypertensive agents and improve or stabilize renal function. The associations of baseline systolic, diastolic, and pulse pressures (PPs) with outcomes of blood pressure (BP) and renal function were examined in 243 patients who underwent renal angioplasty and stent placement. The average PP before the procedure in patients with improvements or stabilizations in renal function was 53 +/- 20 mm Hg, compared to 107 +/- 18 mm Hg (p <0.05) in those with poorer outcomes. The average PPs before procedure were 47 +/- 15 mm Hg in those with improvements in BP, 82 +/- 10 mm Hg in those with stabilizations of BP, and 111 +/- 14 mm Hg in those with worsening BP. All findings were statistically significant (p <0.05). In conclusion, wide PP may reflect more advanced vascular stiffness and renal disease distinguishing patients less likely to benefit from revascularization.
authors.affiliation: Department of Cardiology, Loyola University Medical Center, Maywood, Illinois, USA.
authors.forename: Robert S
authors.initials: RS
authors.lastname: Dieter
authors.forename: Amir
authors.initials: A
authors.lastname: Darki
authors.forename: Aravinda
authors.initials: A
authors.lastname: Nanjundappa
authors.forename: Vikram S
authors.initials: VS
authors.lastname: Chhokar
authors.forename: Ghazanfar
authors.initials: G
authors.lastname: Khadim
authors.forename: Ali
authors.initials: A
authors.lastname: Morshedi-Meibodi
authors.forename: Jeffrey H
authors.initials: JH
authors.lastname: Freihage
authors.forename: Lowell
authors.initials: L
authors.lastname: Steen
authors.forename: Bruce
authors.initials: B
authors.lastname: Lewis
authors.forename: Fred
authors.initials: F
authors.lastname: Leya
mesh_terms: D000368:Aged; D000800:Angioplasty, Balloon; D001794:Blood Pressure; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012078:Renal Artery Obstruction / Q000628:therapy*; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D015607:Stents