PT  - JOURNAL ARTICLE
AU  - S R Sangle
AU  - D P D’Cruz
AU  - W Jan
AU  - M Y Karim
AU  - M A Khamashta
AU  - I C Abbs
AU  - G R V Hughes
TI  - Renal artery stenosis in the antiphospholipid (Hughes) syndrome and hypertension
AID  - 10.1136/ard.62.10.999
DP  - 2003 Oct 01
TA  - Annals of the Rheumatic Diseases
PG  - 999--1002
VI  - 62
IP  - 10
4099  - http://ard.bmj.com/content/62/10/999.short
4100  - http://ard.bmj.com/content/62/10/999.full
SO  - Ann Rheum Dis2003 Oct 01; 62
AB  - Background: Hypertension is common in the antiphospholipid (Hughes) syndrome (APS) and its cause is poorly understood. Anecdotal evidence suggests that renal artery stenosis (RAS) may be a relevant and treatable cause of hypertension. Objective: To investigate the prevalence of RAS in patients with APS and hypertension. Patients and methods: Three groups of patients were evaluated: (1) 77 patients with positive antiphospholipid antibodies (aPL) (60 secondary APS, 11 primary APS, and 6 with aPL only) and uncontrolled hypertension who were receiving two or more antihypertensive drugs; (2) 91 patients (⩽50 years) attending hypertension clinics;(3) 92 normotensive healthy, potential renal transplant donors. Magnetic resonance renal angiography was used to image the renal arteries in all three groups. Results: Group 1: 20/77 (26%) patients had evidence of RAS (16 unilateral and 4 bilateral). Sixteen patients (80%) had smooth well defined stenoses in the proximal third of the renal artery. Three further patients had irregular arteries without distinct stenosis. Group 2: 7/91 (8%) hypertensive patients had RAS (χ2=10.3, p<0.001 v group 1). Group 3: 3/92 (3%) healthy donors had RAS (χ2=18.2, p<0.0001 v group 1). Conclusion: A significantly increased prevalence of RAS (26%) was found in patients with APS and hypertension, compared with relatively young (⩽50 years) hypertensive controls and healthy potential donors.