Relationship between Accessory Renal Artery and Clinical Characteristics of Middle-Aged Patients with Primary Hypertension

Abstract

Objectives. The association between accessory renal artery (ARA) and hypertension remains not fully understood. We observed the association between ARA and clinical characteristics among middle-aged patients with primary hypertension. Methods. One hundred and sixty-two middle-aged (mean 39.82 ± 10.25 years, 58.0% male) patients with primary hypertension were enrolled, and patients underwent Computed Tomography Angiography (CTA) of renal arteries, ambulatory blood pressure monitor (ABPM), echocardiography, physical examination, and routine blood chemistry examinations. According to the CTA results, patients were divided into a non-ARA (n = 108) and ARA (n = 54) group. Direct renin concentration (DRC), plasma aldosterone concentration (PAC), ABPM, echocardiography, creatinine, and glomerular filtration rate were compared between the two groups. Results. DRC (mU/L) (11.21 (5.34, 20.87) vs. 18.24 (10.32, 33.59), P=0.002) was significantly higher in the ARA group than in the non-ARA group. However, PAC (ng/dL) (98.30 (67.30, 134.00) vs. 116.50 (78.80, 137.25), P=0.103) was similar between these two groups. ABPM (mmHg) results showed that daytime (146.75 ± 17.04/95.86 ± 11.39 vs. 155.50 ± 14.76/100.48 ± 10.69, P<0.05), night time (133.44 ± 17.50/85.28 ± 12.80 vs. 139.81 ± 14.64/89.83 ± 11.21, P<0.05), and 24 h blood pressure (143.95 ± 15.99/93.90 ± 11.78 vs. 152.07 ± 13.85/98.11 ± 10.36, P<0.05) were significantly higher in the ARA group than in the non-ARA group. Accordingly, echocardiographic-derived posterior left ventricular wall thickness value was higher in the ARA group than in the non-ARA group. Conclusion. ARA is related to higher blood pressure and higher direct renin concentration in middle-aged patients with primary hypertension, and these patients deserve stricter blood pressure control. Our results provide important evidence for that ARA is a cause of hypertension and target organs damages.

Multidetector computed tomography angiography study of the renal arterial vasculature anatomy and its variations in a Bulgarian adult population

“…Typically, they are small-caliber vessels with lower perfusion pressure which leads to increased renin secretion from the parenchyma irrigated by ARA and activation of the renin-angiotensin system and hypertension. [15] Moreover, their stenosis or occlusion due to atherosclerosis may additionally contribute to the development and worsening of hypertension.…”

Primary Aldosteronism Masked by Accessory Renal Arteries: A Case Report

“…In addition, a previous study showed that the peripheral plasma renin activity was higher in the group with an accessory renal artery compared to a matched control group of hypertensive patients without an accessory renal artery [ 24 ]. Recently, a study found that the plasma renin concentrations were significantly higher in hypertensive patients with an accessory renal artery compared to those without [ 25 ]. Taken together, an accessory renal artery was potentially associated with high renin concentration and might be an overlooked cause of renin-dependent hypertension.…”