Abstract.

Background. Atherosclerotic renal artery stenosis (RAS) is an important cause of secondary hypertension. Little information is available about the incidence of RAS in hypertensive patients in the Upper Egypt society. This study was performed to determine the prevalence of RAS and its related risk factors in hypertensive patients with suspected clinically coronary artery disease (CAD) undergoing coronary angiography.

METHODS: We studied the presence of RAS in 118 consecutive hypertensive patients who underwent coronary angiography in Sohag University Hospital Catheterization Unit for clinically suspected coronary artery disease.(94men, 24 women) aged 33-70 years (mean age: 54±8.5 years). Before catheterization, clinical examination was performed to determine duration and degree of hypertension, cardiac history, other cardiovascular risk factors, and related co-morbidities. Transthoracic Echocardiography was performed. Blood samples for biochemical evaluations including serum creatinine, fasting blood glucose, and fibrinogen were taken. Single plane cine abdominal angiography was performed immediately following coronary angiography utilizing 20—10 mL of non-ionic contrast medium.

RESULTS: According to angiographic data, 91 patients (77.1%) had CAD and 27 (22.9%) had normal coronary arteries. RAS was seen in 22 patients (24.1%) with CAD and hypertension, and in one patient with hypertension and normal coronary arteries. Overall 23 patients (19.4%) had RAS.

Significant RAS (>50% lumen narrowing) was identified in 13 patients (14.2%) and non-significant RAS (<50%) was found in 9 (9.8%) patients. Patients with significant RAS were older (56.8 versus 52.6 years, P<0.05) and were characterized by higher systolic blood pressure level (P=0.006). Multivessel coronary artery disease (MVD) and diabetes were more frequent in patients with significant RAS. Patients with significant RAS had higher left