MR T2* Map to Predict Worsening Hypertension Control: A Preliminary Study

Area of Science:

• Nephrology
• Cardiovascular Medicine
• Radiology

Background:

• Blood pressure monitoring is crucial for hypertension management but offers limited insight into renal status in treated patients.
• Assessing renal oxygenation can provide a more comprehensive understanding of kidney health in hypertensive individuals.

Purpose of the Study:

• To evaluate renal oxygenation in hypertensive patients using T2* mapping.
• To investigate if R2* values derived from T2* mapping can guide antihypertensive treatment adjustments.

Main Methods:

• 140 subjects (87 hypertensive, 53 normotensive) were recruited.
• Hypertensive subjects were categorized by medication (non-medicated, ARB, non-ARB) and blood pressure control (good, poor).
• T2* mapping assessed renal cortical and medullary R2* values over a 2-year follow-up, categorizing patients into stable or unstable treatment groups.

Main Results:

• Unstable hypertension was associated with higher medullary R2* values compared to stable hypertension (p < 0.05).
• The combined non-medicated and ARB-treated unstable subgroup showed significantly higher medullary R2* values overall and within the good control group (p < 0.05).
• Stable hypertension, particularly well-controlled cases managed with lifestyle changes or ARBs, demonstrated lower medullary R2* values, indicating better renal oxygenation.

Conclusions:

• T2* mapping and R2* values offer a non-invasive method to assess renal oxygenation in hypertensive patients.
• Medullary R2* values may serve as a biomarker for predicting treatment stability and guiding antihypertensive therapy adjustments.
• Optimized blood pressure control, especially with ARBs or lifestyle modifications, correlates with improved renal oxygenation.