Morganti A, Quorso P, Ferraris P, Lovaria A, Fruscio M, Saccheri S, Zanchetti A
Istituto di Clinica Medica Generale e Terapia Medica, Università di Milano, Italy.
J Hypertens Suppl. 1989 Dec;7(6):S186-7. doi: 10.1097/00004872-198900076-00089.
We measured arterial pressure and plasma renin activity throughout the first week after a technically successful percutaneous transluminal renal angioplasty (PTRA) in 12 patients with hypertension and unilateral renal artery stenosis. Mean arterial pressure fell from 126 +/- 4 to 105 +/- 3 mmHg within 1-2 days of PTRA and stabilized thereafter; in addition, plasma renin activity decreased sharply during the first 2 days after the angioplasty (from 5.2 +/- 2.3 to 1.3 +/- 0.3 ng/ml per h) but continued to decline, reaching 0.8 +/- 0.2 ng/ml per h at the end of the study. When the antihypertensive effect of PTRA was examined in relation to baseline values of plasma renin activity, the patients with low, intermediate and high plasma renin activity showed percentage decreases in mean arterial pressure of, respectively, 6%, 16% and 19% by the sixth day of observation after the angioplasty. No overall correlation was found between the changes in arterial pressure and those in plasma renin activity induced by PTRA. These data suggest that the beneficial effect of PTRA on blood pressure can be estimated within a few days and that the reduction in the activity of the renin system is the principal but not the sole mechanism responsible for it.
我们对12例高血压合并单侧肾动脉狭窄患者在经皮腔内肾血管成形术（PTRA）技术成功后的第一周内，全程测量了动脉血压和血浆肾素活性。PTRA术后1 - 2天内，平均动脉压从126±4 mmHg降至105±3 mmHg，此后趋于稳定；此外，血管成形术后的头2天内血浆肾素活性急剧下降（从5.2±2.3降至1.3±0.3 ng/ml per h），但继续下降，在研究结束时降至0.8±0.2 ng/ml per h。当根据血浆肾素活性的基线值检查PTRA的降压效果时，血浆肾素活性低、中和高的患者在血管成形术后第六天平均动脉压的下降百分比分别为6%、16%和19%。未发现PTRA引起的动脉压变化与血浆肾素活性变化之间存在总体相关性。这些数据表明，PTRA对血压的有益作用可在数天内评估，肾素系统活性降低是其主要但非唯一的作用机制。
