title: Blood pressure response to renal artery stenting in 901 patients from five prospective multicenter FDA-approved trials.
abstract: BACKGROUND
  Renal artery stent revascularization is commonly used for renovascular hypertension. Clinical predictors associated with blood pressure (BP) improvement after renal artery stent revascularization are not well understood.
  
  
  METHODS
  Patient-level data from 901 patients in five prospective multicenter Food and Drug Administration-approved investigational device exemption studies of renal artery stent revascularization was pooled. BP response was defined as reduction of systolic BP (SBP) by >10 mm Hg. Stent patency was defined within each study. Associations of BP reduction were determined by logistic regression.
  
  
  RESULTS
  Of 901 patients, complete outcome information was available in 527. Of these, 212/527 (40%) were male, mean age was 63 ± 13 years, 196/544 (36%) were diabetic and 504/527 (96%) had a SBP ≥ 140 mm Hg or DBP ≥ 90 mm Hg at baseline. Compared to baseline, 9-month systolic (164 ± 21 mm Hg vs. 146 ± 22 mm Hg, P < 0.0001) and diastolic (79 ± 13 mm Hg vs. 76 ± 12 mm Hg, P < 0.0001) BP declined significantly. Nine-month stent patency was 90% (305/339). In a univariate analysis, baseline SBP >150 mm Hg (OR = 4.09, CI = 2.74-6.12, P < 0.0001) was positively associated with BP response following renal artery stent revascularization. In a multivariable analysis, baseline SBP remained associated with a positive BP response (OR = 1.76, CI = 1.53-2.03, P < 0.0001).
  
  
  CONCLUSIONS
  In the largest pooled dataset of patients treated with renal artery stent revascularization, SBP and DBP were significantly lower at 9-months. Elevated baseline SBP (>150 mm Hg) was strongly associated with BP reduction after the procedure.
authors.affiliation: The Institute for Heart, Vascular and Stroke Care, Massachusetts General Hospital, Boston, Massachusetts.
authors.forename: Ido
authors.initials: I
authors.lastname: Weinberg
authors.forename: Michelle J
authors.initials: MJ
authors.lastname: Keyes
authors.forename: Jay
authors.initials: J
authors.lastname: Giri
authors.forename: Kevin R
authors.initials: KR
authors.lastname: Rogers
authors.forename: Jeffrey W
authors.initials: JW
authors.lastname: Olin
authors.forename: Christopher J
authors.initials: CJ
authors.lastname: White
authors.forename: Michael R
authors.initials: MR
authors.lastname: Jaff
mesh_terms: D000368:Aged; D001794:Blood Pressure; D016009:Chi-Square Distribution; D057510:Endovascular Procedures / Q000009:adverse effects / Q000295:instrumentation*; D005260:Female; D006801:Humans; D006978:Hypertension, Renovascular / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015337:Multicenter Studies as Topic; D015999:Multivariate Analysis; D016017:Odds Ratio; D011446:Prospective Studies; D012078:Renal Artery Obstruction / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D012307:Risk Factors; D015607:Stents; D013997:Time Factors; D016896:Treatment Outcome; D014481:United States; D014486:United States Food and Drug Administration
keywords: ANPE- angiography, peripheral/renal; HTN-hypertension; RADI-renal artery disease; RADI-renal artery disease intervention