Procedural trends and event rates in severe renovascular hypertension

Patients with renovascular hypertension are at increased risk of cardiovascular events compared with the general population1. Several surgical and endovascular renal artery (RA) revascularisation options are available and have demonstrated improvement in blood pressure control for those with atherosclerotic RA stenosis, although the data have been mixed in other populations2. At present, RA stenting is infrequently utilised, likely based on conflicting data (several negative randomised control trials, but multiple positive observational studies and single-arm cohort trials)2. Few contemporary, large-scale studies have evaluated trends in this procedure in the United States or evaluated related events. Our objectives for this study were as follows: 1) to determine recent temporal trends of RA stenting in the USA, and 2) to describe cardiovascular and renal event rates among patients with severe renovascular hypertension requiring stenting.

We included all Medicare fee-for-service beneficiaries >65 years who underwent RA stent placement between 1 January 2016 and 31 December 2020. Subjects were identified in the Centers for Medicare and Medicaid Services’ (CMS) Medicare coverage database using procedural billing codes to identify inpatient and outpatient procedures. Patient...