1, the danger of hypertension The prevalence of hypertension is greater than 10% in people over 15 years old in China, and grows with age. Hypertension is the first cause of acute cerebrovascular disease in China, and also one of the most important risk factors for coronary heart disease, which is one of the main killers that seriously threaten the health of our people. 2.Which kind of hypertension can be cured by surgery? The vast majority of hypertensive patients understand the rationale of long-term drug control of blood pressure and cooperate in treatment, however, there are still many patients with refractory hypertension who still cannot control their blood pressure well through a large number of long-term medications, and even have serious complications such as cerebral infarction, heart attack and renal failure. In fact, in these refractory hypertension, a considerable part does not belong to primary hypertension, but secondary hypertension, these secondary hypertension need to be controlled by treating the primary disease, the use of antihypertensive drugs alone is certainly not effective, in these secondary hypertension, the most important one is the following to introduce to you: “renal vascular hypertension “, this kind of hypertension if the diagnosis is clear, timely treatment, is very good control or even completely cure! And its main treatment method is surgery. 3.What is “renal vascular hypertension”? Renal vascular hypertension refers to renal artery stenosis or atresia caused by arteriosclerosis, arteritis, myofibrillar dysplasia, etc., resulting in high renin secretion and thus hypertension. 4.What conditions should be suspected of renal vascular hypertension? (1) Sudden onset of hypertension before the age of 30 or after the age of 50; (2) Rapid development of hypertension with very high blood pressure and poor effect of taking many antihypertensive drugs; (3) Accompanied by a tendency of deteriorating renal function. Of course, there are many other manifestations, and the ones introduced here are just a few of the main features. If any of these features are met, you should suspect that it may be renal vascular hypertension, and if 2 of them are met, then the possibility of renal vascular hypertension is high. 5.If renal vascular hypertension is suspected, where should I go to confirm the diagnosis? Of course, you should come to the vascular surgery department for examination. Because this disease is beyond the scope of traditional medical hypertension, but is a vascular disease. Generally speaking, an ultrasound of the renal arteries is needed to initially understand whether the renal arteries are narrowed and whether there are abnormal flow rates. Sometimes due to obesity, the ultrasound may not be clear, or need to further understand the specific situation of the renal artery, then it is necessary to further do the renal artery MRI, generally the MRI can clearly see whether the renal artery has narrowing or atresia, as well as the specific scope and severity of the lesion, to decide the next treatment plan. 6.How to treat renal vascular hypertension when it is diagnosed? If a renal artery lesion causing hypertension is identified, a normal renal artery needs to be reconstructed in order to treat it. In the past, when the interventional technology was not yet developed, renal artery bypass was done to solve this problem, the operation was relatively large and risky, but the effect was not bad. In recent years, due to the rapid development of vascular surgery interventional technology in China, most of the renal artery stenosis can be solved by placing stents, which is a minimally invasive treatment with similar surgical results as traditional surgery, while the safety is greatly improved, making it possible for many elderly patients who could not receive surgery before to have the opportunity to be treated. Current statistics show that if the diagnosis is clear, then the probability of patients being able to benefit from the treatment is greater than 80%. Through the surgery, the kidney restores normal blood flow and renin secretion will return to normal. Many patients thus have their blood pressure reduced to normal and have completely got rid of the medicine jar, and some other patients, although they have not achieved such a complete effect, have reduced the dosage of antihypertensive drugs, or their blood pressure which could not be controlled by taking antihypertensive drugs, can now be controlled. 7. Can I still have surgery for hypertension if my blood pressure is very high and I am old? Any treatment has both risks and benefits, including medication, and the older you are, the higher the risk is, of course. Therefore, the doctor’s obligation is to carefully and comprehensively understand the patient’s overall situation, compare the possible risks and benefits faced by the patient in various treatment methods based on his or her experience and knowledge, and then carefully choose an appropriate treatment plan to recommend to the patient, so whether an elderly patient can undergo surgery depends on detailed judgment and specific analysis of the condition before deciding.