Renal Sinus Fat and Poor Blood Pressure Control in Middle-Aged and Elderly Individuals at Risk for Cardiovascular Events

Fat in the renal sinus (RS), a region of the kidney in which low pressure venous and lymphatic vessels are present, may indirectly influence blood pressure. The purpose of this study was to assess the association between RS fat and control of blood pressure on receipt of antihypertensive medications. A total of 205 participants aged 55 to 85 years at risk for cardiovascular events underwent MRI assessments of abdominal and RS fat, measurement of blood pressure, and determination of the number of prescribed antihypertensive medications. Multivariable linear regression was used to determine associations among RS fat, blood pressure, and the number of prescribed antihypertensive medications. Abdominal fat averaged 416 +/- 160 cm(3) (median and interquartile range of 396 cm(3) and 308 to 518 cm(3)); intraperitoneal fat averaged 141 +/- 73 cm(3) (median and interquartile range of 129 cm(3) and 86 to 194 cm(3)); and RS fat averaged 4.6 +/- 3.2 cm(3) (median and interquartile range of 4.2 cm(3) and 2.2 to 6.6 cm(3)). After accounting for age, sex, height, body mass index, and intraperitoneal fat, RS fat correlated with the number of prescribed antihypertensive medications (P=0.010), stage II hypertension (P=0.02), and renal size (P <= 0.001). In conclusion, after accounting for other body fat depots and risk factors for hypertension, RS fat volume is associated with the number of prescribed antihypertensive medications and stage II hypertension. These results indicate that further studies are warranted to determine whether fat accumulation in the RS promotes hypertension. (Hypertension. 2010;56:901-906.)