Prediction of Cure of Hypertension in Atherosclerotic Renal Artery Stenosis

Which patients with hypertension and atherosclerotic renal artery stenosis benefit from immediate intervention?

“…26 Renovascular hypertension is supposed to be more likely in patients in whom the plasma renin activity is increased after stimulation with captopril (captopril-renin challenge test), 16 in patients with an abnormal renogram after stimulation with captopril, 19 and in patients with recently developed hypertension. 20,21 In these subgroups, immediate intervention did not have an apparent benefit over restricting intervention to those patients in whom hypertension persisted or renal function declined after 3 months of drug therapy. This benefit, if any, is small and probably does not outweigh the risks of complications and cost of intervention for patients in whom blood pressure can be controlled medically.…”

“…We studied three subgroups of patients with a supposedly good response to intervention: those with positive captopril-renin challenge test 16,17 (1-h plasma renin X50 mU/ml; this cutoff represents the optimal value for identifying renal artery stenosis in our study group), 18 those with abnormal renogram after stimulation with captopril, 19 and those with recently developed hypertension (within the last 2 years). 20,21 Two subgroups of patients with a supposed risk for rapid disease progression were studied: those with bilateral stenosis (X50% of lumen diameter on both sides), and those with severe stenosis (X80% of lumen diameter). 22,23 Subgroup data were available for all patients except for the captopril-renin challenge test and on captopril renography.…”

Psychogenic tremor disorders identified using tree‐based statistical algorithms and quantitative tremor analysis

“…A tree‐based statistical algorithm is an exploratory method for uncovering structure in data 14, 16. This technique has developed interest outside of medicine although has been increasingly applied in internal medicine, oncology, nephrology, and neurology 17–24. Tree‐based models are simple and efficient when dealing with domains with many variables and marked overlap in data ranges and are an alternative to more traditional linear and logistic classifications.…”