Renal Artery Stenosis in Patients with Resistant Hypertension: Stent It or Not?
Fiche publication
Date publication
janvier 2017
Journal
Current hypertension reports
Auteurs
Membres identifiés du Cancéropôle Est :
Pr ROSSIGNOL Patrick
Tous les auteurs :
Van der Niepen P, Rossignol P, Lengelé JP, Berra E, Sarafidis P, Persu A
Lien Pubmed
Résumé
After three large neutral trials in which renal artery revascularization failed to reduce cardiovascular and renal morbidity and mortality, renal artery stenting became a therapeutic taboo. However, this is probably unjustified as these trials have important limitations and excluded patients most likely to benefit from revascularization. In particular, patients with severe hypertension were often excluded and resistant hypertension was either poorly described or not conform to the current definition. Effective pharmacological combination treatment can control blood pressure in most patients with renovascular hypertension. However, it may also induce further renal hypoperfusion and thus accelerate progressive loss of renal tissue. Furthermore, case reports of patients with resistant hypertension showing substantial blood pressure improvement after successful revascularization are published over again. To identify those patients who would definitely respond to renal artery stenting, properly designed randomized clinical trials are definitely needed.
Mots clés
Blood Pressure, Humans, Hypertension, complications, Renal Artery, Renal Artery Obstruction, complications, Stents, Treatment Outcome
Référence
Curr. Hypertens. Rep.. 2017 Jan;19(1):5