PMID- 3589964
OWN - NLM
STAT- MEDLINE
DCOM- 19870630
LR  - 20041117
IS  - 0039-6060 (Print)
IS  - 0039-6060 (Linking)
VI  - 101
IP  - 6
DP  - 1987 Jun
TI  - Surgical treatment of renovascular hypertension caused by arteriosclerosis. I. 
      Influence of preoperative factors on blood pressure control early and late after 
      reconstructive surgery.
PG  - 698-705
AB  - This study evaluates the long-term efficacy of reconstructive surgery for 
      renovascular hypertension caused by arteriosclerosis, which was performed on 112 
      patients from 1959 to 1983. Despite medical therapy, all patients had persistent 
      hypertension, with a mean preoperative blood pressure of 188/113 mm Hg. Their 
      median age was 49 years, and the median duration of objectively documented 
      hypertension was 21 months at the time of surgery. Manifestations of extrarenal 
      arteriosclerosis (ERA) were present in 57 patients (51%). Results were evaluated 
      both at a short-term (ST) interval (mean: 8.4 months) and at a long-term (LT) 
      interval (mean: 8.9 years) postoperatively. Patients were classified by means of 
      strict criteria as cured, improved, or unsuccessfully treated. If a patient was 
      cured or if his condition improved, this was considered a beneficial blood 
      pressure response. Beneficial responses were maintained during LT follow-up, 
      since the respective percentages for cure and improvement were 24% and 50% at the 
      ST interval and 18% and 61% at the LT interval. These results had not been 
      influenced by either older age or the presence of ERA, since results were similar 
      in patients older and younger than the median age and in those with and without 
      ERA. The preoperative duration of hypertension was the only pertinent clinical 
      feature that influenced the LT interval results, LT beneficial responses were 
      observed in 95% of the patients with a shorter duration and in 78% of those with 
      a longer duration of preoperative hypertension than the median (p = 0.01). We 
      conclude that surgical therapy for renovascular hypertension caused by 
      arteriosclerosis can effectively reduce blood pressure and that this result is 
      maintained during LT follow-up. In terms of anticipated blood pressure response, 
      older age, longer duration of hypertension, and the presence of ERA do not 
      exclude surgical therapy.
FAU - van Bockel, J H
AU  - van Bockel JH
FAU - van Schilfgaarde, R
AU  - van Schilfgaarde R
FAU - Felthuis, W
AU  - Felthuis W
FAU - Hermans, J
AU  - Hermans J
FAU - van Brummelen, P
AU  - van Brummelen P
FAU - Terpstra, J L
AU  - Terpstra JL
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Surgery
JT  - Surgery
JID - 0417347
SB  - IM
MH  - Adult
MH  - Aged
MH  - Arteriosclerosis/complications/physiopathology/*surgery
MH  - *Blood Pressure
MH  - Endarterectomy
MH  - Female
MH  - Follow-Up Studies
MH  - Humans
MH  - Hypertension, Renovascular/etiology/physiopathology/*surgery
MH  - Male
MH  - Middle Aged
MH  - Postoperative Period
MH  - Renal Artery/*surgery
MH  - Splenorenal Shunt, Surgical
EDAT- 1987/06/01 00:00
MHDA- 1987/06/01 00:01
CRDT- 1987/06/01 00:00
PHST- 1987/06/01 00:00 [pubmed]
PHST- 1987/06/01 00:01 [medline]
PHST- 1987/06/01 00:00 [entrez]
AID - 0039-6060(87)90083-3 [pii]
PST - ppublish
SO  - Surgery. 1987 Jun;101(6):698-705.