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  • Angioplasty was no better than medication for reducing blood pressure or slowing disease progression in renal artery stenosis

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Therapeutics
Angioplasty was no better than medication for reducing blood pressure or slowing disease progression in renal artery stenosis

https://doi.org/10.1136/ebm.5.6.171

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    (2000) N Engl J Med 342, 1007. van Jaarsveld BC, Krijnen P, Pieterman H. , et al, for the Dutch Renal Artery Stenosis Intervention Cooperative Study Group.. The effect of balloon angioplasty on hypertension in atherosclerotic renal-artery stenosis.. Apr 6;. :. –14.
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 QUESTION: In patients with atherosclerotic renal artery stenosis who have normal or mildly impaired renal function, is balloon angioplasty as effective as antihypertensive drug treatment for reducing blood pressure?

    Design

    Randomised (allocation concealed*), blinded {outcome assessors}†,* controlled trial with 12 months follow up.

    Setting

    26 clinical centres in the Netherlands.

    Patients

    106 patients (mean age 60 y, 62% men) with renal artery stenosis measured by renal arteriography (reduction in luminal diameter ≥50%) and normal to mildly impaired renal function (serum creatinine level ≤2.3 mg/dl [200 μmol/l]). Exclusion criteria were cancer, hypertension caused by a condition other than renovascular disease, unstable coronary artery disease, heart failure, or pregnancy. Follow up was 98%.

    Intervention

    56 patients were allocated to …

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    Footnotes

    • Source of funding: Dutch Health Insurance Executive Board.

    • For correspondence: Dr B C van Jaarsveld, Dianet Dialysis Centres, Brennerbaan 130, 3524 BN Utrecht, the Netherlands. Fax +31 30 281 7094.

    • ↵* See glossary.

    • ↵† Information provided by author.