Accessory Renal Arteries are Not Related to Hypertension Risk: A Propensity Score-Matching Analysis.

Objective: The relationship between accessory renal arteries (ARAs) and hypertension remains controversial. This study aimed to investigate the influence of ARAs on hypertension. Methods: A retrospective analysis was conducted on 1,113 patients with essential hypertension. The patients were divided into ARA and non-ARA groups based on computed tomography angiography of renal arteries, and propensity score matching (PSM) was applied to balance baseline characteristics between the two groups. Results: ARAs were present in 67.5% of the patients (751 in the ARA group, 362 in the non-ARA group). After PSM, each group included 362 patients with balanced baseline characteristics. No significant differences were observed between the groups in 24-hour mean blood pressure, echocardiographic measurements (including left atrial diameter, left ventricular end-diastolic diameter, interventricular septal thickness and left ventricular posterior wall thickness), and renal function indicators (including serum creatinine, blood uric acid and urinary microalbumin levels) after PSM. Moreover, among the patients screened after adequate drug washout, there were no differences in the levels of direct renin concentration and plasma aldosterone concentration between the two groups before and after PSM. Conclusions: ARAs are a common anatomical variation of the renal vasculature and are unlikely to be major contributors to elevated blood pressure or more serious target organ damage in patients with essential hypertension.