粥样硬化性肾动脉狭窄合并高血压患者RAAS活性及介入术后血压改善影响因素分析OA北大核心CSTPCD

Aim:To investigate the renin-angiotensin-aldosterone system(RAAS)activity in patients with atheroscle-rotic renal artery stenosis(ARAS)and hypertension and influencing factors of the improvement of blood pressure after endo-vascular therapy.Methods:A total of 69 patients with ARAS combined with hypertension diagnosed by renal arteriography who attended Henan Provincial People's Hospital from January 2018 to June 2023(ARAS group)were selected,and 138 age and gender-matched patients with essential hypertension(EH)admitted during the same period were included at a ratio of 1∶2.Clinical characteristics such as demographic information and duration of hypertension were analyzed in the EH and ARAS groups,and RAAS activity was compared among EH,unilateral ARAS,and bilateral ARAS groups.Renal function of ARAS patients was compared before and after endovascular therapy,and the factors influencing the improvement of blood pressure in ARAS patients after the intervention were analyzed using Logistic regression.Results:Compared with the EH group,BMI,comorbidity ratio,systolic blood pressure,pulse pressure and serum creatinine were higher in the ARAS group,the duration of hypertension,estimated glomerular filtration rate(eGFR)and serum potassium were lower in the ARAS group(P<0.05).Compared with the EH group,the unilateral ARAS group had higher plasma renin activity,angiotensinⅡ,and aldosterone,and lower aldosterone-to-renin ratio and serum potassium;the bilateral ARAS group had higher plasma renin activity and lower serum potassium(P<0.017).Plasma aldosterone concentration was lower in the bilateral ARAS group compared with the unilateral ARAS group(P<0.017).There was no significant difference in renal function before and after endovascular therapy in ARAS patients(P>0.05).eGFR(OR=0.928,95%CI was 0.875-0.984,P=0.012)was associated with improvement of blood pressure after endovascular therapy in ARAS patients.Conclusion:RAAS is acti-vated in ARAS and hypertension patients;patients with lower preoperative eGFR are more likely to have improved blood pressure via endovascular therapy.