Abstract
Introduction: According to the non-specific presentation of atherosclerotic renal artery stenosis (ARAS), this disease is usually an under-diagnosed in clinical conditions. Objectives: The aim of the presence study was to evaluate the prevalence of renal artery stenosis (RAS) and its related risk factors in hypertensive patients undergoing coronary angiography. Patients and Methods: In a cross-sectional study, between March 2009 and October 2010, all of hypertensive patients candidate for diagnostic cardiac catheterization, underwent nonselective renal angiography before completion of their coronary angiography procedure. A standardized questionnaire was used to collect demographics, cardiac history, indications for cardiac catheterization and angiographic data. The degree of ARAS was estimated visually by skilled cardiologist. Narrowing greater than 50% of the arterial lumen considered as arterial stenosis. Data was analyzed by SPSS version 19, and by chi-square test and logistic regression model. Results: In overall 274 patients with mean age of 60.75 ± 10.92 years 108 (39.4%) were male and 166 (60.61%) were female. The prevalence of ARAS calculated 18.2%. According to the present study, heart failure and smoking were predictors of ARAS. However, old age, gender, diabetes mellitus, hyperlipidemia and family history of cardiovascular disease were not clinical predictors of significant ARAS in hypertensive patients, candidate for coronary angiography. Conclusion: According to present data, we suggest to consider renal artery angiography in combination with coronary artery angiography especially in hypertensive patients who are smoker or individuals who have heart failure.
Highlights
According to the non-specific presentation of atherosclerotic renal artery stenosis (ARAS), this disease is usually an under-diagnosed in clinical conditions
Implication for health policy/practice/research/medical education: Considering that atherosclerotic renal artery stenosis (ARAS) is prevalent in hypertensive patients undergoing coronary angiography, screening for early diagnosis of ARAS is crucial for saving renal function and prevents others complication and prolongs patients life, all by timely intervention
Considering that ARAS is prevalent in hypertensive patients and since there is no data about the prevalence of ARAS in our region and due to the fact that identifying predictive risk factor for ARAS in individuals who are suspected for coronary artery disease (CAD) is of great importance, this study provides a golden opportunity for timely intervention which can improve ARAS clinical course and prognosis
Summary
According to the non-specific presentation of atherosclerotic renal artery stenosis (ARAS), this disease is usually an under-diagnosed in clinical conditions. Objectives: The aim of the presence study was to evaluate the prevalence of renal artery stenosis (RAS) and its related risk factors in hypertensive patients undergoing coronary angiography. Old age, gender, diabetes mellitus, hyperlipidemia and family history of cardiovascular disease were not clinical predictors of significant ARAS in hypertensive patients, candidate for coronary angiography. Conclusion: According to present data, we suggest to consider renal artery angiography in combination with coronary artery angiography especially in hypertensive patients who are smoker or individuals who have heart failure. The prevalence of RAS in individuals with suspected CAD who underwent coronary angiography was reported 11.3% to 39% by some studies [1]. Due to high coexistence of ARAS and CAD in cases with angiography diagnosed CAD [10] it has been advised renal angiography be performed in conjunction with coronary angiography [9]
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