| Primary hyperaldosteronism: a frequent cause of residual hypertension after successful endovascular treatment of renal artery disease. | |
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MedLine Citation:
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PMID: 16208147 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Poor blood pressure control in renal artery disease patients after percutaneous renal angioplasty (PTRA), with or without stenting (PTRAS), may be due to pre-existing hypertension. Primary hyperaldosteronism is much more frequent than was previously suspected. We hypothesized that residual hypertension observed in some renal artery disease patients after technically successful endovascular treatment may be due to primary hyperaldosteronism. METHODS: Only patients free of significant residual artery stenosis were included in the study. Aldosterone and renin were measured in 52 renal artery disease patients (8 with fibrodysplastic and 44 with atherosclerotic lesions), in whom successful PTRA/PTRAS had been performed previously. An aldosterone-to-renin ratio > or = 23 pg/ml per pg/ml was considered as the cut-off value for performing tests to confirm the diagnosis of primary hyperaldosteronism. RESULTS: Residual hypertension (blood pressure > or = 160/90 mmHg) was observed in 24/52 patients (46%) after revascularization. A raised aldosterone-to-renin ratio was found in nine subjects (17.3%), eight of whom had poor blood pressure control (33% of patients with residual hypertension). A diagnosis of primary hyperaldosteronism was confirmed in seven patients (four atherosclerotic, three fibrodysplastic). All fibrodysplastic subjects with unresponsive blood pressure after PTRA were affected by primary hyperaldosteronism. Primary hyperaldosteronism was confirmed in 9% (4/44) of the atherosclerotic patients (19% of subjects with residual hypertension). No specific clinical features were associated with the subsequent blood pressure control. CONCLUSIONS: Primary hyperaldosteronism is a frequently neglected cause of residual hypertension despite technically successful endovascular treatment of renal artery disease. |
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Authors:
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Francesca Pizzolo; Chiara Pavan; Patrizia Guarini; Elisabetta Trabetti; Domenico Girelli; Roberto Corrocher; Oliviero Olivieri |
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Publication Detail:
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Type: Comparative Study; Evaluation Studies; Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Journal of hypertension Volume: 23 ISSN: 0263-6352 ISO Abbreviation: J. Hypertens. Publication Date: 2005 Nov |
Date Detail:
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Created Date: 2005-10-06 Completed Date: 2006-02-28 Revised Date: 2006-11-15 |
Medline Journal Info:
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Nlm Unique ID: 8306882 Medline TA: J Hypertens Country: England |
Other Details:
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Languages: eng Pagination: 2041-7 Citation Subset: IM |
Affiliation:
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Unit of Internal Medicine, Department of Clinical and Experimental Medicine, University of Verona, Italy. |
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| MeSH Terms | |
Descriptor/Qualifier:
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Aged Aldosterone / blood Angioplasty, Balloon* Blood Pressure / physiology Blood Vessel Prosthesis Implantation Female Follow-Up Studies Glomerular Filtration Rate Humans Hyperaldosteronism / complications, therapy* Hypertension, Renovascular / blood, etiology, physiopathology Male Middle Aged Postoperative Complications / blood, etiology, physiopathology Renal Artery Obstruction / complications, therapy Renin / blood Stents Treatment Outcome Vascular Surgical Procedures |
| Chemical | |
Reg. No./Substance:
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52-39-1/Aldosterone; EC 3.4.23.15/Renin |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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