Many people have the impression that hypertension needs to be treated by long-term control of drugs, and the patient Lao Hao originally thought the same way, but as a result, he took a lot of drugs, but his blood pressure was not under control, but was going up. Recently, Mr. Hao was diagnosed in our department that his hypertension was special, and the cause was in the renal artery, which was confirmed by arteriography to be left renal artery stenosis. However, what exactly is Mr. Hao’s disease? Normal people generally have two kidneys, the kidneys are very rich in blood flow, the blood output from the heart is transported through the renal artery to the kidneys, normal blood flow is essential to ensure the operation of kidney function, the kidneys also have a very close relationship with blood pressure, more than 80% of kidney disease patients have high blood pressure. Renal artery stenosis is a partial blockage of the lumen of the renal artery due to atheromatous plaque, etc. Many people are not familiar with this disease, but in fact the incidence of renal artery stenosis is very high, more so in elderly people, patients with diabetes, coronary heart disease, hyperlipidemia and smoking. Renal artery stenosis can cause clinical manifestations such as hypertension (newly developed hypertension, or progressive exacerbation of pre-existing hypertension), hyperalgesia, recurrent acute pulmonary edema, proteinuria and renal atrophy, but many patients are asymptomatic. More importantly, renal artery stenosis is also a common cause or aggravation of renal failure. Since renal hyperalgesia caused by renal artery stenosis can often be reversed after correction of the stenosis, early detection and selection of appropriate treatment is very important. 1. What is renal hypertension Renal hypertension is the most common type of secondary hypertension, accounting for about 5% to 10% of hypertensive patients. There are many causes of renal artery stenosis, such as atherosclerosis, abnormal fibromuscular development, polyarteritis, renal artery insufficiency, etc. 2, what are the clinical manifestations of renal hypertension (1) more common in people under 30 years old; (2) shorter history; (3) sudden onset of significant hypertension, or sudden aggravation of the original hypertension; (4) no family history of hypertension (5) antihypertensive drugs are not effective; (6) doctors in the patient’s upper abdomen or lumbar spinal rib area auscultation, can hear a vascular murmur; (7) history of lumbar trauma. Of course, finally, we have to rely on renal arteriography to confirm the diagnosis. 3.How to detect renal artery stenosis There are many diagnostic methods for renal artery stenosis, which are mainly divided into non-invasive and invasive tests. Non-invasive tests mainly include ultrasound, CT angiography and magnetic resonance angiography; invasive tests mainly refer to renal artery angiography. Although noninvasive tests can help determine the presence of renal artery stenosis, renal artery angiography is still the “gold standard” for the diagnosis of renal artery stenosis, and if necessary, interventional treatment can also be performed on the stenosed renal artery at the same time.