title: Incidence and risk factors for restenosis, and its impact on blood pressure control after percutaneous transluminal renal angioplasty in hypertensive patients with renal artery stenosis.
abstract: Percutaneous transluminal renal angioplasty (PTA) is one of the standard treatments for renal artery stenosis (RAS). We investigated the frequency and risk factors for restenosis, and its impact on blood pressure (BP) control.
  
  
  
  A total of 175 hypertensive patients with RAS [mean age 60 years; 34% women; 30.3% fibromuscular dysplasia (FMD)] with 207 treated renal arteries were included and followed for more than 1 year without reangioplasty. Diagnosis of restenosis was based on duplex ultrasonographic findings, and data including BP and antihypertensive medication were collected consecutively.
  
  
  
  During follow-up (mean, 5.1 years), 56 patients (32.0%) developed restenosis. In multivariate Cox regression analysis, FMD was an independent predictor of restenosis (hazard ratio 2.65, P < 0.05). When divided into two groups based on FMD or atherosclerotic RAS (ARAS), the presence of previous cardiovascular disease (hazard ratio 2.84) as well as severe RAS (≥90%) (hazard ratio 3.95) in ARAS were independent predictors of restenosis (P < 0.05, respectively). At 1 year after PTA, 35 patients (20.0%) had developed restenosis. When divided into four groups on the basis of FMD or ARAS, and the absence/presence of restenosis at 1 year, the number of antihypertensive drugs was significantly lower in both FMD and ARAS patients without restenosis (P < 0.01, respectively); however, a significant difference in decrease in SBP (-31 ± 19 vs. -12 ± 25 mmHg, P < 0.05) as well as cure of hypertension (36.4 vs. 5.0%, P < 0.01) between the absence/presence of restenosis was found only in FMD patients.
  
  
  
  The frequency of restenosis after renal PTA is significant, and the presence of restenosis diminishes the benefit of its treatment, especially for FMD.
authors.affiliation: aDivision of Hypertension and Nephrology bDepartment of Radiology, National Cerebral and Cardiovascular Center cDivision of Health Science, Osaka University Graduate School of Medicine, Osaka dDepartment of General Internal Medicine 3, Kawasaki Medical School, Okayama eDepartment of Medical Technology, Teikyo University, Fukuoka, Japan.
authors.forename: Yoshio
authors.initials: Y
authors.lastname: Iwashima
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Fukuda
authors.forename: Fumiki
authors.initials: F
authors.lastname: Yoshihara
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Kusunoki
authors.forename: Masatsugu
authors.initials: M
authors.lastname: Kishida
authors.forename: Shin-Ichiro
authors.initials: S
authors.lastname: Hayashi
authors.forename: Satoko
authors.initials: S
authors.lastname: Nakamura
authors.forename: Kei
authors.initials: K
authors.lastname: Kamide
authors.forename: Takeshi
authors.initials: T
authors.lastname: Horio
authors.forename: Yuhei
authors.initials: Y
authors.lastname: Kawano
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017130:Angioplasty; D000959:Antihypertensive Agents / Q000627:therapeutic use; D001161:Arteriosclerosis / Q000150:complications*; D001794:Blood Pressure; D005260:Female; D005352:Fibromuscular Dysplasia / Q000453:epidemiology*; D005500:Follow-Up Studies; D006801:Humans; D006973:Hypertension / Q000188:drug therapy / Q000503:physiopathology*; D015994:Incidence; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012078:Renal Artery Obstruction / Q000453:epidemiology* / Q000209:etiology / Q000503:physiopathology* / Q000601:surgery; D012307:Risk Factors; D012720:Severity of Illness Index; D055815:Young Adult
chemical_list: D000959:Antihypertensive Agents