RENOVASCULAR STENOSIS IS MORE PROBABLE IN PATIENTS WITH CORONARY ARTERY DISEASE WHO HAVE HIGH BLOOD PRESSURE DESPITE TREATMENT WITH ANTI-ISCHEMIC DRUGS

Background- Patients with coronary artery disease have a predilection for the ‎development of remote atherosclerosis and may be expected to be at greater risk of ‎renal artery stenosis. This study assesses the patients with high suspicion of coronary ‎artery disease who have high blood pressure (>140/90 mmHg) in spite of treatment ‎with anti-ischemic drugs (combination of beta-blocker, calcium channel blocker and ‎nitrate).‎ ‎
‎ Methods- The severity of renal and coronary stenoses were quantified in 57 patients ‎‎(mean age 52.3 ± 3.5 y) with evidence of coronary artery disease and high blood ‎pressure who were on anti-ischemic drug therapy. These patients underwent selective ‎or nonselective renal artery angiography as part of a diagnostic cardiac catheterization ‎study at our center between March 1999 and March 2002‎‏.‏‎
‎ Results- Coronary artery disease was seen in 82.5% of these patients, which was ‎significant (>50%) in 66.7% of them. Renal artery stenosis of any degree was seen in ‎‎42% of the patients. 28% of the patients had significant (50%) renal artery stenosis. ‎There was a good correlation between the severity of coronary and renal artery ‎stenoses (p=0.016). Also, there was a correlation between the number of involved ‎coronary and renal arteries (p=0.019).‎ ‎
‎ Conclusions- In patients with clinical evidence of coronary artery disease who have ‎high blood pressure in spite of treatment with combined anti-ischemic drug therapy, ‎renal artery study during cardiac cathetreization is a logical and useful decision ‎‎(Iranian Heart Journal 2002, 2003; 3(4)& 4(1): 21-24).‎