Renal Resistive Index and Cardiovascular and Renal Outcomes in Essential Hypertension

Doi, Yasufumi; Iwashima, Yoshio; Yoshihara, Fumiki; Kamide, Kei; Hayashi, Seiichiro; Kubota, Yukihiko; Nakamura, Satoko; Horio, Takeshi; Kawano, Yuhei

doi:10.1161/hypertensionaha.112.196717

Cited by 112 publications

(97 citation statements)

References 40 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Increased RRI indicates the presence of hypertensive and atherosclerotic organ damage such as left ventricular hypertrophy (LVH) and carotid intima-media thickening and may therefore be taken as an indicator of increased cardiovascular risk profile [5][6][7][8][9][10][11].…”

Section: Introductionmentioning

confidence: 99%

Renal resistive index in patients with true resistant hypertension: results from the RESIST-POL study

et al. 2016

View full text Add to dashboard Cite

A b s t r a c tBackground: Increased ultrasound Doppler renal resistive index (RRI) is a marker of atherosclerotic and hypertensive organ damage both at renal and systemic level. Aim:To evaluate RRI in patients with true resistant hypertension (TRHT) in the RESIST-POL study. Methods:From 204 patients diagnosed with TRHT in the RESIST-POL study, 151 patients (90 male, 61 female, mean age: 47.7 ± 10.4, range: 19-65 years) without secondary hypertension were included into the analysis. All patients were characterised by estimated glomerular filtration rate > 60 mL/min/1.73 m 2 and no history of diabetes prior to the study. As a control group we included 50 age-and gender-matched patients (35 male, 15 female, mean age: 46.8 ± 10.4, range: 19-65 years) with primary well-controlled hypertension. The groups also did not differ in respect to the number of years of known history of hypertension. The RRIs were evaluated on the basis of the Doppler ultrasound examination. Increased RRI was defined as ≥ 0.7. Results:Both groups did not differ in terms of renal function. Patients with TRHT were characterised by higher RRI as compared with the group with well-controlled hypertension (0.62 ± 0.05 vs. 0.60 ± 0.05, p < 0.05). In the TRHT group RRI correlated significantly with age, clinic and ambulatory blood pressure measurement, diastolic blood pressure (DBP) levels, as well as with clinic pulse pressure (PP) (r = 0.297; p = 0.001), with daytime (r = 0.355; p < 0.001) and nighttime (r = 0.313; p < 0.001) PP, and with fasting glucose concentration (r = 0.215; p = 0.008) and E/E' ratio (r = 0.289; p = 0.001) on echocardiography. RRI values were significantly higher in TRHT patients with newly diagnosed diabetes as compared with TRHT patients without diabetes (0.65 ± 0.05 vs. 0.62 ± 0.05, p = 0.022). Age, daytime DBP, daytime PP, and E/E' ratio but not fasting glucose concentration correlated independently with RRI in the model. Among patients with TRHT, patients with increased RRI were characterised by older age (52.2 ± 4.9 vs. 47.3 ± 10.6 years, p = 0.012), higher body mass index (32.8 ± 6.0 vs. 29.7 ± 4.5 kg/m 2 , p = 0.034), as well as lower daytime and nighttime DBP values and lower daytime and nighttime heart rate, as compared to patients with RRI < 0.7. The TRHT patients with increased RRI as compared to patients with RRI < 0.7 were characterised also by higher daytime and nighttime PP. Both groups did not differ in respect of renal function. Conclusions:Our study showed that the patients with TRHT were characterised by significantly higher RRI values as compared to the subjects with well-controlled hypertension. It may also be suggested that in the subjects with TRHT renal vascular resistance is related to blood pressure values, selected echocardiographic abnormalities, and some surrogate markers for metabolic and cardiovascular events, including fasting glucose plasma concentration and PP, respectively. www.kardiologiapolska.plRenal resistive index in patients with true resistant hypertension: results from the RESIST-POL...

show abstract

Section: Introductionmentioning

confidence: 99%

Renal resistive index in patients with true resistant hypertension: results from the RESIST-POL study

et al. 2016

View full text Add to dashboard Cite

show abstract

“…Of particular importance may be baseline renal function because the estimated glomerular filtration rate (eGFR) in the study by Wu et al 8 was substantially lower than that in the study by Sechi et al 7 The RI, which is calculated based on systolic and diastolic flow velocity, has been shown to correlate significantly with histological findings, such as arteriosclerosis and tubulointerstitial changes. [9][10][11] In addition, increased renal RI was reported to be significantly associated with the incidence of cardiovascular and renal organ damage 12,13 and to serve as a predictor of worsening renal function in patients with chronic kidney disease. 14,15 In patients with APA, plasma aldosterone levels decrease drastically after adrenalectomy.…”

mentioning

confidence: 99%

Renal Resistive Index Predicts Postoperative Blood Pressure Outcome in Primary Aldosteronism

et al. 2016

View full text Add to dashboard Cite

show abstract

“…In the September issue of Hypertension, Doi et al 1 analyzed the prognostic implications of elevated ultrasound renal resistive indices (RRI) in hypertensive subjects without overt cardiovascular disease. In line with earlier studies among patients with chronic kidney disease and among kidney allograft recipients, elevated RRI were found to predict adverse outcome.…”

Section: Renal Resistive Index and Cardiovascular And Renal Outcomes mentioning

confidence: 99%

“…In line with earlier studies among patients with chronic kidney disease and among kidney allograft recipients, elevated RRI were found to predict adverse outcome. 1 Doi et al 1 should be commended for their efforts to better characterize implications of renal ultrasound measurements. Nonetheless, some words of caution should be raised.…”

Section: Renal Resistive Index and Cardiovascular And Renal Outcomes mentioning

confidence: 99%