Incidental renal artery stenosis in hypertensive patients undergone coronary angiography

Objective:To evaluate the prevalence of renal stenosis in hypertensive patients population undergoing routine coronary angiography,and to identify the risk factors for renal stenosis.Method:Before the procedure,demographic data,medical history,physical findings sere obtained.In 157 patients(81 male,76 female),mean systolic blood pressure was (151.5±17.4)mmHg,and mean diastolic blood pressure was (94.7±10.3) mmHg.After coronary angiography,selective or non_selective renal artery angiography was performed to screen for the presence of renal artery stenosis.An univariate and multivariate Logistic regression analysis were made to explore the association of renal artery stenosis with the clinical variables,including age,sex,systolic blood pressure,diastolic blood pressure,hyperlipidemia,smoking,diabetic mellitus and severity of coronary artery disease.Result:Of the 157 patients,126 patients(80.2%) had normal renal arteries,and 31 patients(19.6%) had renal artery stenosis,including 17 patients(10.8%) had renal artery 30%_50% stenosis,and 14 patients(8.9%) had stenoses of 50% or more.Significant unilateral stenosis(≥70%) was present in 6(3.8%) patients and bilateral stenosis was present in 2(1.2%) patient.There were 79 cases with coronary artery disease and 78 subjects without coronary artery disease.Of the all patients with coronary artery disease,there were 29 single_vessel,25 double_vessel,21 triple_vessel disease and 4 left main disease accompanying with triple_vessel disease.An univariate analysis showed age,systolic blood pressure,diabetic mellitus and severity of coronary artery disease were associated with renal artery stenosis.In multivariate analysis,age(OR=1.17,95% CI:1.05_1.38,P0.01) and severity of coronary artery disease(OR=1.46,95% CI:1.03_2.04,P0.01) independently correlated with renal artery stenosis.Conclusion:The prevalence of incidental renal artery stenosis among hypertensive patients undergoing coronary catheterization is significant.Therefore,screening nenal arteriograyrly should be considered in hypertensive patients undergoing coronary angiography.