Renal Artery Stenosis and Hypertension: II. Mortality in Operated Patients Compared with the Mortality in Individually Matched Medically Treated Patients with Cryptogenetic Hypertension

Abstract

Sixty-four patients, operated for renal artery stenosis and with observation times varying between 1 and 10 years, were individually matched against 64 partners selected from a medically treated series of 461 patients with the diagnosis of essential hypertension, where treatment had been initiated 1957-1960. The matching characteristics were age, sex, eye-grounds, serum creatinine, highest and lowest systolic and diastolic blood pressures, heart volume and ECG. Only 21 of the 64 operated patients had observation times longer than four years. During this time, there was no such difference in the number of deaths as to counter-balance the deaths occurring immediately postoperatively. The twelve deaths in the operated series occurred entirely in the two thirds of the material in which the stenosis was considered of atherosclerotic origin. This demonstrable atherosclerosis in one or two arteries is estimated to imply a higher risk for occlusive vascular disease in other areas, irrespective of the careful matching procedure. The somewhat better degree of blood pressure control might, after prolonged observation, conceivably more than counter-balance the mortality encurred immediately in connection with the operation.