title: Arterial stiffness in atherosclerotic renovascular hypertension.
abstract: OBJECTIVE
  Arterial stiffness is an independent cardiovascular risk factor. Aging, high blood pressure and increased renin-angiotensin system activity contribute to increased arterial stiffness in patients with atherosclerotic renovascular hypertension (aRVH). A literature search failed to identify any study related to this topic. Therefore, our aim was to determine the arterial stiffness in patients with aRVH and analyze whether stenting in addition to multifactorial drug therapy has beneficial effects on markers of stiffness and the clinical course.
  
  
  METHODS
  In this 6-month longitudinal study, 37 patients with refractory hypertension and unilateral aRVH were enrolled. After stenting, all patients received multifactorial dug therapy including 80 mg of telmisartan. Arterial stiffness indices were determined using Arteriograph. The control group consisted of 44 patients with essential hypertension.
  
  
  RESULTS
  There were no differences in brachial blood pressure values between the two groups (P > 0.05). At baseline, adjusted pulse wave velocity (PWV) was higher in aRVH patients than that of essential hypertensive patients (12.8 ± 0.4 vs. 11.6 ± 0.3 m/s; P = 0.029). In the aRVH group, at the end of the follow-up, a significant decrease in the aortic augmentation index (37.7 ± 9.9 vs. 33.7 ± 11.4; P = 0.02) without changes in PWV was observed (P > 0.05).
  
  
  CONCLUSIONS
  This study is the first to show that arterial stiffness is higher in patients with refractory aRVH than in those with essential hypertension. Multifactorial therapy based on stenting and intensive medical treatment reduced central blood pressure and augmentation index. Failure to obtain PWV reduction is likely a consequence of the present irreversible structural vessel changes. Longer follow-up might enable us to resolve whether arterial stiffness indices have better predictive ability in patients with aRVH than brachial blood pressure.
authors.affiliation: aDepartment for Nephrology, Hypertension, Dialysis and Transplantation bDepartment for Diagnostic and Interventional Radiology, University Hospital Zagreb, School of Medicine, University of Zagreb, Zagreb, Croatia.
authors.forename: Ljiljana
authors.initials: L
authors.lastname: Fodor
authors.forename: Vedran
authors.initials: V
authors.lastname: Premužić
authors.forename: Vanja
authors.initials: V
authors.lastname: Ivković
authors.forename: Dražen
authors.initials: D
authors.lastname: Perkov
authors.forename: Mario
authors.initials: M
authors.lastname: Laganović
authors.forename: Tajana Zeljković
authors.initials: TZ
authors.lastname: Vrkić
authors.forename: Zivka
authors.initials: Z
authors.lastname: Dika
authors.forename: Marijana
authors.initials: M
authors.lastname: Zivko
authors.forename: Bojan
authors.initials: B
authors.lastname: Jelaković
mesh_terms: D000368:Aged; D047228:Angiotensin II Type 1 Receptor Blockers / Q000627:therapeutic use; D001011:Aorta / Q000503:physiopathology; D050197:Atherosclerosis / Q000150:complications; D001562:Benzimidazoles / Q000627:therapeutic use; D001565:Benzoates / Q000627:therapeutic use; D001794:Blood Pressure / Q000187:drug effects; D001795:Blood Pressure Determination; D000075222:Essential Hypertension; D005260:Female; D006801:Humans; D006973:Hypertension / Q000503:physiopathology / Q000628:therapy; D006978:Hypertension, Renovascular / Q000209:etiology / Q000503:physiopathology* / Q000628:therapy; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D063177:Pulse Wave Analysis; D012084:Renin-Angiotensin System; D012307:Risk Factors; D015607:Stents; D000077333:Telmisartan; D059289:Vascular Stiffness
chemical_list: D047228:Angiotensin II Type 1 Receptor Blockers; D001562:Benzimidazoles; D001565:Benzoates; D000077333:Telmisartan