Randomised controlled trial
Fractional flow reserve-guided renal artery stenting in atherosclerotic renovascular hypertension: the FAIR randomized trial
- Randomised controlled trial
Authors' conclusion
FFR-guided revascularization significantly reduced unnecessary stenting compared with angiography-guided revascularization. Both blood pressure and antihypertensive medication usage decreased significantly after stenting in patients with FFR < 0.80.
Study context
- Population
- Patients with atherosclerotic renal artery stenosis (ARAS) and hypertension
- Participants
- 101 patients
- Comparison
- Fractional flow reserve (FFR)-guided vs angiography-guided renal revascularization
- Primary endpoint
- Percentage changes in ambulatory daytime mean SBP (DMSBP) and composite index of antihypertensive medicines (CIAHM)
- Follow-up
- 3 months
Primary result
As reported in the abstract
% change in daytime mean SBP (DMSBP) and composite index of antihypertensive medicines (CIAHM)
% change in daytime mean systolic blood pressure (DMSBP) did not differ between groups: 4% [−2%, 11%] vs 4% [−3%, 10%]
P = .97
% change in composite index of antihypertensive medicines (CIAHM) did not differ between groups: 0% [0%, 3%] vs 1% [0%, 4%]
P = .33
Further findings
Rate of stenting
P < 0.01
Effect of stenting by FFR (vs FFR ≥ 0.80 without stenting)
- FFR < 0.80: adjusted mean DMSBP reduction
- 6.2 mmHg (95% CI 0.6-11.9)
- FFR < 0.80: mean CIAHM reduction
- 3.1 (95% CI 1.5-4.7)
- FFR ≥ 0.80: DMSBP reduction
- 1.4 mmHg (95% CI −4.5-7.2)
- FFR ≥ 0.80: CIAHM reduction
- 0.7 (95% CI −1.1-2.5)
Original publication
Fractional flow reserve-guided renal artery stenting in atherosclerotic renovascular hypertension: the FAIR randomized trial. Eur Heart J. Published 7 October 2025. doi:10.1093/eurheartj/ehaf746
Summarised from the published abstract; every number is checked against it