Recently we treated two similar cases, which are very educational and remind the general patients. Both were elderly men. Patient A had a history of hypertension for more than 10 years and had been taking oral antihypertensive 0 for a long time with fair blood pressure control, but in the past month, his blood pressure increased significantly, up to 200/100 mmHg, with occasional episodes of dizziness, and he was seen in several hospitals, where he was given sleep improvement and a variety of antihypertensive drugs with poor control. The patient was found to have a history of hypokalemia and was considered to have risk factors for atherosclerosis such as smoking, hypertension, and elderly males, etc. No significant murmur was detected on auscultation, and a renal artery ultrasound screening was recommended, which confirmed that the right renal artery was severely stenosed. The patient underwent renal arteriography, which revealed a 90% stenosis of the right renal artery opening, and was given a stent implantation. Patient B came to our department for further diagnosis and treatment because of back pain for many years, which was considered to be caused by kidney stones in the outside hospital, with poor results. Ultrasound examination of renal arteries revealed severe stenosis of bilateral renal artery openings and slowed blood flow, and renal diagram suggested severely reduced perfusion in both kidneys and significantly reduced renal function. The above two cases, similar conditions, different treatment results, the reason is mainly the different timing of consultation, patient B came too late, the kidneys have been atrophied, can not change the results of dialysis, so early detection and early treatment is very important. So, what kind of hypertensive patients are suspected to have renal artery stenosis? 1.Previously had hypertension, and suddenly blood pressure cannot be controlled recently. 2, middle-aged and elderly patients, no previous history of hypertension, sudden onset of hypertension and poor drug control. 3, hypertension combined with lumbar pain, exclude ureteral calculi. 4, hypertension combined with hypokalemia. 5, unexplained heart failure episodes, etc. We all know the acute coronary syndrome of coronary heart disease, which should be treated in hospital as soon as possible, or else the consequences are serious. For renal artery stenosis, I think there is also “acute renal artery syndrome”, in which the renal artery is severely stenosed and occluded, leading to severe ischemia of the kidney. If the patient is treated in time, the result will be as good as my patient A, with good protection of renal function and good control of blood pressure, which is very ideal; if the treatment is delayed or misdiagnosed, the patient may also need dialysis treatment soon, like my patient B. Therefore, renal artery stenosis should be given full attention and early detection and treatment. How to treat renal artery stenosis? On the basis of anti-atherosclerosis, anti-platelet and renal protection treatment, stent implantation is the most important treatment method. Because the diameter of renal artery is thicker than that of coronary artery, so the forward blood flow is good, the risk of thrombosis and restenosis is small, and the prognosis is better than that of coronary stent; moreover, we are now carrying out renal artery stent implantation from the right radial artery, which is less traumatic, quicker recovery, and immediately after surgery, truly minimally invasive and humane.