For people who have a diseased kidney
artery, which can cause high blood pressure, balloon angioplasty is no better
than medications for keeping blood pressure under control, according to a new
report.
During angioplasty, a balloon-tipped catheter is threaded into a blocked
artery and inflated, flattening fatty plaques against the artery wall. This
procedure is often used to clear a kidney artery in people with high blood
pressure, but the long-term benefits of angioplasty remain in doubt, according
to a team of researchers led by Dr. Brigit C. van Jaarsveld, of the Erasmus
University Hospital in Rotterdam, the Netherlands.
In the new study, 106 patients with high blood pressure and hardening of the
kidney artery were treated with either angioplasty or drugs to lower blood
pressure. Patients who underwent angioplasty stopped taking blood pressure
medications after having the procedure, but they could be prescribed the drugs
again if their blood pressure did not drop enough.
At the beginning of the study, blood pressure readings were similar in both
groups. Three months into the trial, average blood pressure did not differ
significantly between the two groups, the researchers report in the April 6th
issue of The New England Journal of Medicine. And a year after the study began,
blood pressure was still about the same in each group. However, 22 of the 50
people in the drug therapy group underwent angioplasty after 3 months when their
blood pressure remained high.
Angioplasty did provide at least one additional benefit, however. People who
underwent the procedure took fewer drugs to control blood pressure -- about one
less drug in the usual dose per day.
Based on the results, the researchers conclude that angioplasty should only
be used to treat patients whose blood pressure remains high even after treatment
with three or more medications, or whose kidney artery is becoming increasingly
clogged.
