title: Prevalence of and risk factors of renal artery stenosis in patients with resistant hypertension.
abstract: Renal artery stenosis (RAS) is a common cause of secondary hypertension. Renal artery angiography is the gold standard for diagnosing RAS. The aim of this study is to report (1) the prevalence of RAS in patients with resistant hypertension and (2) the association of RAS with peripheral vascular disease (PVD) and diabetes mellitus (DM). We studied 285 consecutive patients (mean age: 72.5 years) with resistant hypertension (systolic blood pressure >140 mm Hg despite administration of at least 3 antihypertensive drugs) who underwent renal artery angiography at Baylor Heart and Vascular Hospital from January 2006 to December 2010. Sixty-nine cases of RAS were identified (incidence: 24.2%). The propensity-adjusted analysis (controlling for clinical and nonclinical risk factors) showed a strong and significant association between RAS and PVD (odds ratio 5.15, 95% confidence interval 2.68 to 9.89, p <0.0001). However, the association between RAS and DM, a previously defined risk factor for RAS, was not significant in this cohort (odds ratio 0.63, 95% confidence interval 0.34 to 1.19, p = 0.16). In conclusion, results from this study define the prevalence of RAS in patients with resistant hypertension. Patients with PVD were found to be 5 times more likely to experience RAS than patients without PVD, whereas DM did not confer any increased risk.
authors.affiliation: Department of Internal Medicine, Baylor University Medical Center, Dallas, Texas. Electronic address: minamecheal@yahoo.com.
authors.forename: Mina M
authors.initials: MM
authors.lastname: Benjamin
authors.affiliation: Division of Cardiology, Department of Internal Medicine, Baylor Heart and Vascular Institute, Baylor University Medical Center, Dallas, Texas.
authors.forename: Poorya
authors.initials: P
authors.lastname: Fazel
authors.affiliation: Department of Epidemiology, Institute for Health Care Research and Improvement, Baylor Health Care System, Dallas, Texas.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Filardo
authors.affiliation: Division of Cardiology, Department of Internal Medicine, Baylor Heart and Vascular Institute, Baylor University Medical Center, Dallas, Texas.
authors.forename: James W
authors.initials: JW
authors.lastname: Choi
authors.affiliation: Division of Cardiology, Department of Internal Medicine, Baylor Heart and Vascular Institute, Baylor University Medical Center, Dallas, Texas; Texas A&M Health Science Center, College of Medicine, Dallas, Texas.
authors.forename: Robert C
authors.initials: RC
authors.lastname: Stoler
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000792:Angiography; D003430:Cross-Sectional Studies; D003920:Diabetes Mellitus / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications* / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D016491:Peripheral Vascular Diseases / Q000150:complications* / Q000000981:diagnostic imaging; D015995:Prevalence; D057216:Propensity Score; D012078:Renal Artery Obstruction / Q000150:complications / Q000000981:diagnostic imaging / Q000453:epidemiology*; D012307:Risk Factors