[PP.25.17] EFFECT OF RENAL ARTERY ANGIOPLASTY ON AMBULATORY BLOOD PRESSURE IN PATIENTS WITH RESISTANT HYPERTENSION AND ATHEROSCLEROTIC RENAL ARTERY STENOSIS

Objective: The blood pressure impact of renal artery angioplasty in patients with resistant hypertension and atherosclerotic renal artery stenosis (ARAS) has not been fully investigated since the majority of trial excluded these patients. The aim of the present study was to assess the benefit of renal angioplasty on daytime ambulatory blood pressure monitoring (dABPM) in this subgroup. Design and method: Medical records of our hypertension department were retrospectively analysed from 2000 to 2016. 72 patients were identified with resistant hypertension (dABPM > 135/85 mmHg despite at least 3 antihypertensive drugs including a diuretic) and treated by renal artery angioplasty. Results: 57 patients had unilateral ARAS and 15 had bilateral ARAS. Mean age was 67.8 ± 11.2 years; dABPM was 157 ± 16/82 ± 10 mmHg despite 4.0 ± 1.0 antihypertensive treatments and eGFR was 52 [41–63] mL/min. After renal angioplasty dABPM decreased by 14.0 ± 17.3/6.4 ± 8.7 mmHg (p < 0.001 for both) concomitantly of a decrease of antihypertensive treatment (p = 0.002) and no significant changes of eGFR (53 [42–67] mL/min, p = 0.630). Independent predictors of systolic dABPM changes were high baseline systolic dABPM, high body mass index and low plasma aldosterone concentration. The decrease of dABPM was confirmed in a subgroup of patients at 1 and 3 years of follow-up (N = 31 and N = 18 respectively, p < 0.001 for systolic and diastolic at the different visits). Conclusions: In this retrospective study renal angioplasty in patients with resistant hypertension and ARAS demonstrated a significant decrease of dABPM and of antihypertensive treatment without affecting eGFR.