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Schulte KL, Spies KP, van Gemmeren D, et al. Screening and Diagnostik zum Ausschluss einer renovaskulären Hypertonie. Stellenwert der 24-Stunden-Blutdruckmessung und der farbkodierten Duplexsonographie. [Screening and diagnosis for eliminating renovascular hypertension. Value of 24-hour blood pressure monitoring and color-coded duplex ultrasound diagnosis]. Med Klin (Munich). 1997;92(6):313-8doi: 10.1007/BF03044769.
Schulte, K. L., Spies, K. P., van Gemmeren, D., Lenz, T., Gotzen, R., Distler, A., & Fobbe, F. (1997). Screening and Diagnostik zum Ausschluss einer renovaskulären Hypertonie. Stellenwert der 24-Stunden-Blutdruckmessung und der farbkodierten Duplexsonographie. [Screening and diagnosis for eliminating renovascular hypertension. Value of 24-hour blood pressure monitoring and color-coded duplex ultrasound diagnosis]. Medizinische Klinik (Munich, Germany : 1983), 92(6), 313-8. https://doi.org/10.1007/BF03044769
Schulte, K L, et al. "Screening and Diagnostik zum Ausschluss einer renovaskulären Hypertonie. Stellenwert der 24-Stunden-Blutdruckmessung und der farbkodierten Duplexsonographie." [Screening and diagnosis for eliminating renovascular hypertension. Value of 24-hour blood pressure monitoring and color-coded duplex ultrasound diagnosis]. Medizinische Klinik (Munich, Germany : 1983) vol. 92,6 (1997): 313-8. doi: https://doi.org/10.1007/BF03044769
Schulte KL, Spies KP, van Gemmeren D, Lenz T, Gotzen R, Distler A, Fobbe F. Screening and Diagnostik zum Ausschluss einer renovaskulären Hypertonie. Stellenwert der 24-Stunden-Blutdruckmessung und der farbkodierten Duplexsonographie. [Screening and diagnosis for eliminating renovascular hypertension. Value of 24-hour blood pressure monitoring and color-coded duplex ultrasound diagnosis]. Med Klin (Munich). 1997 Jun 15;92(6):313-8. doi: 10.1007/BF03044769. German. PMID: 9297061.
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Med Klin (Munich). 1997 Jun 15;92(6):313-8. doi: 10.1007/BF03044769.

[Screening and diagnosis for eliminating renovascular hypertension. Value of 24-hour blood pressure monitoring and color-coded duplex ultrasound diagnosis].

Medizinische Klinik (Munich, Germany : 1983)

[Article in German]
K L Schulte, K P Spies, D van Gemmeren, T Lenz, R Gotzen, A Distler, F Fobbe

Affiliations

  1. Medizinische Klinik, Evangelisches Krankenhaus Königin Elisabeth Herzberge Berlin.

PMID: 9297061 DOI: 10.1007/BF03044769

Abstract

BACKGROUND: Direct renal angiography is still the method of choice for identification of renal artery stenosis. Newer non-invasive diagnostic methods include color coded duplex sonography and also ambulatory 24-h blood pressure monitoring, since in a large proportion of patients with secondary forms of hypertension the usual blood pressure fall during nighttime disappears.

PATIENTS AND METHODS: In a prospective in-hospital study we investigated 86 patients with suspected renovascular hypertension. Circadian blood pressure was measured oscillometrically and color coded duplex sonography was performed immediately before direct renal angiography.

RESULTS: Angiography revealed renal artery stenosis (> or = 50%) in 42 patients. This compared to a sensitivity of 92.9% and specificity of 91.7% for the use of sonography in those patients (70.4%) who could be adequately examined. Mean 24-h pressure values as well as standard deviations of blood pressure means as an indicator for blood pressure variability were not different in the 2 groups of patients, when all the data were analysed together and also when the data for nighttime and daytime were examined separately. The percent of blood pressure fall during nighttime was also not different in the 2 groups. In both groups 4 hypertensive patients had a blood pressure increase during nighttime. In 11 patients without renal artery stenosis a blood pressure fall of < 10% was observed, compared to 12 patients with renal artery stenosis. The circadian pattern of pulse rate was similar in both groups.

CONCLUSION: We conclude that ambulatory blood pressure monitoring has a considerably lower diagnostic value for renal artery stenosis compared to angiography and also to color duplex sonography. This method therefore does not appear to be an appropriate screening approach for this kind of secondary hypertension. The color coded duplex sonography, however, seems to be the best non-invasive diagnostic method in those patients, who can be adequately examined.

References

  1. Am J Med. 1986 Apr;80(4):633-44 - PubMed
  2. Urol Radiol. 1989;11(3):142-7 - PubMed
  3. Circulation. 1990 Feb;81(2):528-36 - PubMed
  4. J Hypertens Suppl. 1990 Dec;8(6):S49-55 - PubMed
  5. Vasa Suppl. 1989;27:235-6 - PubMed
  6. J Hypertens Suppl. 1990 Dec;8(6):S33-8 - PubMed
  7. Am J Cardiol. 1992 Aug 15;70(4):468-73 - PubMed
  8. Am Heart J. 1979 Jan;97(1):35-7 - PubMed
  9. Br J Radiol. 1988 Mar;61(723):196-201 - PubMed
  10. Rofo. 1995 May;162(5):412-9 - PubMed
  11. J Hypertens. 1988 May;6(5):393-6 - PubMed
  12. Z Kardiol. 1991 Aug;80(8):523-8 - PubMed
  13. Kidney Int. 1984 May;25(5):824-9 - PubMed
  14. J Vasc Surg. 1986 Nov;4(5):450-6 - PubMed
  15. J Hypertens Suppl. 1989 May;7(3):S25-8 - PubMed
  16. J Vasc Surg. 1996 Mar;23(3):428-35 - PubMed
  17. Arch Mal Coeur Vaiss. 1988 Jun;81 Spec No:247-50 - PubMed
  18. Rofo. 1991 Mar;154(3):242-5 - PubMed
  19. Circulation. 1990 Feb;81(2):700-2 - PubMed
  20. Z Kardiol. 1991;80 Suppl 1:21-7 - PubMed
  21. J Vasc Surg. 1988 Feb;7(2):363-9 - PubMed
  22. Am J Hypertens. 1993 Sep;6(9):786-93 - PubMed
  23. Z Kardiol. 1991;80 Suppl 1:1-7 - PubMed
  24. BMJ. 1994 Mar 5;308(6929):630-2 - PubMed
  25. J Hypertens Suppl. 1988 Dec;6(4):S458-60 - PubMed
  26. J Hypertens Suppl. 1990 Dec;8(6):S71-5 - PubMed
  27. J Cardiovasc Surg (Torino). 1962 Aug;3:259-62 - PubMed
  28. J Vasc Surg. 1984 Jan;1(1):192-201 - PubMed
  29. Internist (Berl). 1991 Mar;32(3):127-34 - PubMed
  30. Kidney Int. 1991 Jun;39(6):1232-9 - PubMed
  31. Klin Wochenschr. 1990 Aug 17;68(16):830-4 - PubMed
  32. JAMA. 1992 Dec 16;268(23):3353-8 - PubMed

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