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副肾动脉与高血压风险无关:一项倾向评分匹配分析。

Accessory Renal Arteries are Not Related to Hypertension Risk: A Propensity Score-Matching Analysis.

作者信息

Liang Min, Sun Peiwei, Zhang Yongqiang, Bian Bo, Yang Xia, Yang Qing

机构信息

Department of Cardiology, Tianjin Medical University General Hospital.

Tianjin Medical University.

出版信息

Acta Cardiol Sin. 2025 Jul;41(4):481-490. doi: 10.6515/ACS.202507_41(4).20250224E.

Abstract

OBJECTIVE

The relationship between accessory renal arteries (ARAs) and hypertension remains controversial. This study aimed to investigate the influence of ARAs on hypertension.

METHODS

A retrospective analysis was conducted on 1,113 patients with essential hypertension. The patients were divided into ARA and non-ARA groups based on computed tomography angiography of renal arteries, and propensity score matching (PSM) was applied to balance baseline characteristics between the two groups.

RESULTS

ARAs were present in 67.5% of the patients (751 in the ARA group, 362 in the non-ARA group). After PSM, each group included 362 patients with balanced baseline characteristics. No significant differences were observed between the groups in 24-hour mean blood pressure, echocardiographic measurements (including left atrial diameter, left ventricular end-diastolic diameter, interventricular septal thickness and left ventricular posterior wall thickness), and renal function indicators (including serum creatinine, blood uric acid and urinary microalbumin levels) after PSM. Moreover, among the patients screened after adequate drug washout, there were no differences in the levels of direct renin concentration and plasma aldosterone concentration between the two groups before and after PSM.

CONCLUSIONS

ARAs are a common anatomical variation of the renal vasculature and are unlikely to be major contributors to elevated blood pressure or more serious target organ damage in patients with essential hypertension.

摘要

目的

副肾动脉(ARA)与高血压之间的关系仍存在争议。本研究旨在探讨ARA对高血压的影响。

方法

对1113例原发性高血压患者进行回顾性分析。根据肾动脉计算机断层血管造影将患者分为ARA组和非ARA组,并应用倾向评分匹配(PSM)来平衡两组之间的基线特征。

结果

67.5%的患者存在ARA(ARA组751例,非ARA组362例)。PSM后,每组包括362例基线特征平衡的患者。PSM后,两组在24小时平均血压、超声心动图测量指标(包括左心房直径、左心室舒张末期直径、室间隔厚度和左心室后壁厚度)以及肾功能指标(包括血清肌酐、血尿酸和尿微量白蛋白水平)方面均未观察到显著差异。此外,在经过充分药物洗脱筛选的患者中,PSM前后两组之间的直接肾素浓度和血浆醛固酮浓度水平均无差异。

结论

ARA是肾血管系统常见的解剖变异,不太可能是原发性高血压患者血压升高或更严重靶器官损害的主要原因。

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