The Hypotensive Mechanism of Percutaneous Transluminal Dilatation(PTD) in Renovascular Hypertension Due to Bilateral Renal Artery Stenosis

Shuichi Sasaki, Yutaka Imai, Keishi Abe, Minoru Nihei, Naoyoshi Minami, Masanori Munakata, Kaoru Yoshinaga, Hisao Sasaki, Hiroshsi Sekino

Research output: Contribution to journalArticlepeer-review

2 Citations (Scopus)

Abstract

The hypotensive mechanism of percutaneous transluminal dilatation (PTD) in renovascular hypertension due to bilateral renal artery was investigated in two patients. Blood pressure was monitored continously before, during and after PTD by use of a new automated blood pressure monitoring device based on finger volume-oscillometry. Plasma renin activity was measured repeatedly before, during and after PTD. A hypotensive effect appeared immediately after PTD and blood pressure remained low in the following observation period without any hypotensive medication. In these cases, the hypotension was accompanied by a transient decrease in heart rate immediately after PTD. The hypotensive response to PTD was not parallel to the basal plasma renin activity, suggesting that the renin-angiotensin system is not necessarily involved in the maintenance of the hypertension before PTD. The autonomic nervous system seemed to play a certain role. Since the hypotension was accompanied by a transient decrease in heart rate immediately after PTD, the hypotension may be induced either by a decrease in sympathetic tone or by an increase in vagal tone at least just after PTD. It is hypothesized that these changes in autonomic nervous activity are mediated centrally through the renal afferent mechanism in response to rapid changes in renal hemodynamics induced by PTD.

Original languageEnglish
Pages (from-to)173-183
Number of pages11
Journalthe tohoku journal of experimental medicine
Volume154
Issue number2
DOIs
Publication statusPublished - 1988
Externally publishedYes

Keywords

  • autonomic nervous system
  • percutaneous transluminal dilatation
  • reninagniotensin system
  • renovascular hypertension

ASJC Scopus subject areas

  • Biochemistry, Genetics and Molecular Biology(all)

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