scholarly journals Proper Patient Selection Yields Significant and Sustained Reduction in Systolic Blood Pressure Following Renal Artery Stenting in Patients With Uncontrolled Hypertension: Long-Term Results From the HERCULES Trial

2014 ◽  
Vol 16 (7) ◽  
pp. 497-503 ◽  
Author(s):  
George S. Chrysant ◽  
Mark C. Bates ◽  
Timothy M. Sullivan ◽  
William B. Bachinsky ◽  
Jeffrey J. Popma ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Renal Artery ◽  
Systolic Blood Pressure ◽  
Patient Selection ◽  
Long Term Results ◽  
Uncontrolled Hypertension ◽  
Renal Artery Stenting ◽  
Proper Patient Selection ◽  
Sustained Reduction

scholarly journals Long-term mortality after renal artery stenting in patients with severe atherosclerotic renal artery stenosis and high-risk clinical manifestations

2021 ◽  
Author(s):  
M I Dregoesc ◽  
S D Bolboacă ◽  
P M Doroltan ◽  
M Istrate ◽  
M C Marc ◽  
...  
Keyword(s):  
Blood Pressure ◽  
High Risk ◽  
Renal Artery ◽  
Renal Artery Stenosis ◽  
Clinical Manifestations ◽  
Artery Stenosis ◽  
Uncontrolled Hypertension ◽  
Renal Artery Stenting ◽  
Long Term Mortality

Abstract Background Atherosclerotic renal artery stenosis is a risk factor for cardiovascular death. Observational studies support the benefit of renal revascularization on outcomes in selected patients with high-risk clinical manifestations. In this context, we evaluated the factors associated with long-term mortality after renal artery stenting in patients with severe renal artery stenosis, impaired kidney function and/or uncontrolled hypertension. Methods The medical records of patients undergoing renal artery stenting between 2004 and 2014 were extracted. Blood pressure and creatinine were recorded at baseline, 24 hours post-stenting and in the one month to one year interval that followed revascularization. Long-term follow-up was performed in March 2020. Results The cohort consisted of 65 patients. Median follow-up was 120 months. In the first year after stenting, less patients had chronic kidney disease (CKD) class 3b – 5 as compared to baseline (35.3 vs. 56.9%, p=0.01). The number of patients with controlled blood pressure after revascularization increased with 69.2% (p<0.001). Long-term all-cause mortality reached 44.6%. Age (OR 1.1; 95%CI 1.0–1.2; p=0.01), male gender (OR 7.9; 95%CI 1.9 – 43.5; p=0.008), post-stenting CKD class 3b-5 (OR 5.8; 95%CI 1.5–27.9; p=0.01), and post-revascularization uncontrolled hypertension (OR 8.9; 95%CI 1.7–63.5; p=0.01) were associated with long-term mortality independent of diabetes mellitus and coronary artery disease. Conclusion Improved CKD class and blood pressure were recorded in the first year after renal artery stenting in patients with severe renal artery stenosis and high-risk clinical manifestations. The lack of improvement in kidney function and blood pressure was independently associated with long-term mortality.

scholarly journals Renal Artery Stenting Associated With Improvement in Renal Function and Blood Pressure Control in Long-Term Follow-Up

2016 ◽  
Vol 41 (3) ◽  
pp. 278-287 ◽  
Author(s):  
Krzysztof Milewski ◽  
Wojciech Fil ◽  
Piotr Buszman ◽  
Małgorzata Janik ◽  
Wojciech Wanha ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Renal Function ◽  
Renal Artery ◽  
Blood Pressure Control ◽  
Pressure Control ◽  
Renal Artery Stenting ◽  
Long Term Follow Up

P3570Bilateral renal artery stenting is effective method for the treatment of uncontrolled hypertension and renal function

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
J Uzokov ◽  
A L Alyavi ◽  
B A Alyavi ◽  
S A Iskhakov ◽  
D D Payziev
Keyword(s):  
Blood Pressure ◽  
Renal Function ◽  
Serum Creatinine ◽  
Renal Artery ◽  
Uncontrolled Hypertension ◽  
Renal Artery Stenting ◽  
Group I ◽  
Group Ii ◽  
Bilateral Stenting

Abstract Background Renal artery (RA) stenosis is one of the main causes of severe uncontrolled primary hypertension among population. Aim of the study was to investigate effectiveness of stent replacement in renal arteries and influence it on renal function in uncontrolled hypertensive patients (UHP) with pharmacotherapies. Methods 86 consecutive UHP with renal etiology confirmed by angiography were enrolled in this study. Mean age of the patients was 43.2±12.5 years (aged 31–59 years, male=46%). Blood pressure, serum creatinine, microalbuminuria were assessed at baseline and after the intervention and during the follow-up for statistics. Mean follow-up was 2.0±1.0 years. Results Total of 128 hemodynamically significant renal artery stenosis were treated by implanting stents in all 86 patients. Among them in 42 patients were performed bilateral stenting (Group I) and 44 patients unilateral stenting (Group II). Systolic and diastolic blood pressure (SBP, DBP) decreased in both groups during the follow-up, however it was noted that only SBP were decreased significantly in Group I (unilateral stenting) whilst reduction in DBP not significantly when compared to Group II. Mean reduction in SBP was from 165.0±20.5 mmHg to 130.4±14.0 mmHg in Group I vs. from 158.0±22.0 to 135.0±15.0 mmHg in Group II (P=0.003 when compared two groups) and in DBP was from 95.0±11.2 mmHg to 83.4±8.0 mmHg in Group I vs. from 93.0±10.0 to 82.0±7.5 mmHg in Group II (P>0.05 when compared two groups). Serum creatinine levels were reduced from 123.0±49.0 μmol/l to 85.4±30.6 μmol/l in Group I vs 116.8±51.2 μmol/l to 86.9±35.5 μmol/l (P<0.05 when compared two groups). Significantly reduction in MAU were noted in both groups (P<0.05) but when compared two groups there were no significant changes in reduction. Conclusion Renal artery stenting is effective method for the treatment of UHP and may improve outcomes of the patients. Bilateral stenting seems to be more effective in blood pressure and serum creatinine control in UHP.

Long-term effects (>24 months) of multiple lifestyle intervention on major cardiovascular risk factors among high risk subjects: a meta-analysis

2021 ◽  
Vol 28 (Supplement_1) ◽  
Author(s):  
H Bergum ◽  
I Sandven ◽  
TO Klemsdal
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Cardiovascular Risk ◽  
Systolic Blood Pressure ◽  
Total Cholesterol ◽  
Cardiovascular Risk Factors ◽  
Lifestyle Intervention ◽  
Small Study ◽  
Long Term Effects

Abstract Funding Acknowledgements Type of funding sources: Public grant(s) – National budget only. Main funding source(s): The Norwegian health department Background The evidence of the long-term effects of multiple lifestyle intervention on cardiovascular risk is uncertain. We aimed to summarize the evidence from randomized clinical trials examining the efficacy of lifestyle intervention on major cardiovascular risk factors in subjects at high cardiovascular risk. Methods  Eligible trials investigated the impact of lifestyle intervention versus usual care with minimum 24 months follow-up, reporting more than one major cardiovascular risk factor. A literature search updated April 15, 2020 identified 12 eligible studies. The results from individual trials were combined using fixed and random effect models, using the standardized mean difference (SMD) to estimate effect sizes. Small-study effect was evaluated, and heterogeneity between studies examined by subgroup and meta-regression analyses considering patient- and study-level variables. Results  Small-study effect was not identified. Lifestyle intervention reduced systolic blood pressure modestly with an estimated SMD of -0.13, 95% confidence interval (CI): -0.21 to -0.04, with moderate heterogeneity (I² = 59%), corresponding to a mean difference of approximately 2 mmHg (MD = -1.86, 95% CI: -3.14 to -0.57, p = 0.0046). This effect disappeared in the subgroup of trials judged at low risk of bias (SMD = 0.02, 95% CI: -0.08 to 0.11). For the outcome total cholesterol SMD was -0.06, 95% CI: -0.13 to 0.00, with no heterogeneity (I² = 0%), indicating no effect of the intervention. Conclusion  Lifestyle intervention resulted in only a modest effect on systolic blood pressure and no effect on total cholesterol after 24 months. Further lifestyle trials should consider the challenge of maintaining larger long-term benefits to ensure impact on cardiovascular outcomes.

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