title: Efficacy of 24-Hour Blood Pressure Monitoring in Evaluating Response to Percutaneous Transluminal Renal Angioplasty.
abstract: BACKGROUND
  Percutaneous transluminal renal angioplasty (PTRA) improves patency in atherosclerotic renal artery stenosis (ARAS), but improvement in clinic blood pressure (BP) is seen in only 20-40% of patients who undergo PTRA. This study investigated the effects of PTRA on BP lowering, assessed on 24-h ambulatory BP monitoring (ABPM), and identified preoperative features predictive of satisfactory BP improvement after PTRA.
  
  
  RESULTS
  Of 1,753 consecutive patients undergoing coronary angiography, 31 patients with angiographically significant ARAS and translesional pressure gradient (TLPG) >20 mmHg underwent PTRA. ABPM was performed before, at 1 month and at 1 year after PTRA; patients with average systolic ABPM-BP decrease >10 mmHg at 1 month from baseline were categorized as responders. There was no obvious relationship between clinic BP and ABPM-BP at baseline. ABPM-BP was significantly higher in responders at baseline (SBP: 148 vs. 126 mmHg, P<0.01) and was improved 1 month after PTRA. This difference persisted until 1 year after PTRA. Night-time BP improved more than daytime BP in responders. Patients with higher baseline ABPM-BP achieved a larger decrease in ABPM-BP, but the severity of stenosis reflected by TLPG; renal duplex findings; and neurohumoral parameters other than baseline renal function, did not differ between the groups.
  
  
  CONCLUSIONS
  Clinic BP does not represent daily hemodynamic status, whereas high ABPM-BP is a potent predictor of satisfactory BP response to PTRA. (Circ J 2016; 80: 1922-1930).
authors.affiliation: Department of Cardiology, Tokyo Women's Medical University.
authors.forename: Kentaro
authors.initials: K
authors.lastname: Jujo
authors.forename: Katsumi
authors.initials: K
authors.lastname: Saito
authors.forename: Issei
authors.initials: I
authors.lastname: Ishida
authors.forename: Yuho
authors.initials: Y
authors.lastname: Furuki
authors.forename: Taisuke
authors.initials: T
authors.lastname: Ouchi
authors.forename: Ahsung
authors.initials: A
authors.lastname: Kim
authors.forename: Yuki
authors.initials: Y
authors.lastname: Suzuki
authors.forename: Haruki
authors.initials: H
authors.lastname: Sekiguchi
authors.forename: Junichi
authors.initials: J
authors.lastname: Yamaguchi
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Ogawa
authors.forename: Nobuhisa
authors.initials: N
authors.lastname: Hagiwara
mesh_terms: D000368:Aged; D017130:Angioplasty; D001794:Blood Pressure; D018660:Blood Pressure Monitoring, Ambulatory; D017023:Coronary Angiography; D005260:Female; D006801:Humans; D008297:Male; D012078:Renal Artery Obstruction / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery