Fibrous infarction of the small renal arteries is a symptom of primary malignant hypertension. So, how to prevent hypertension caused by small renal artery with fibroinfarction? The following is a brief introduction: 1, the speed and goal of lowering blood pressure: in addition to combined hypertensive encephalopathy, severe congestive heart failure, acute myocardial infarction and other malignant hypertension need to lower blood pressure as soon as possible, most uncomplicated malignant hypertension need not also avoid the rapid reduction of blood pressure to normal in a short period of time, in order to prevent the kidneys and cardiac and cerebral ischemia aggravated. Usually the blood pressure decline in 24h not more than 20%, blood pressure in 24 to 48h to 160-170/100-110mmHg (21.3-22.7/13.3-14.7kPa) is appropriate, for long-term history of hypertension and elderly patients, the process of lowering blood pressure is more appropriate slowly. 2, the choice of antihypertensive drugs: angiotensin-converting enzyme inhibitors (ACEI) according to the important role played by RAS in the development of malignant hypertension, it is not difficult to understand ACEI as the drug of choice not only has a good antihypertensive effect, and can effectively protect the target organs and improve vascular damage. Oral or sublingual captopril 10-50mg can effectively treat malignant hypertension, and its oral onset of action is within 15-30min. If no decrease in blood pressure is observed after 30min, ACEI may have no significant hypotensive effect on the patient. In addition to having good effects on lowering systemic blood pressure, ACEI has excellent renal protection and ameliorates vascular injury, including (1) reducing Ang II-mediated renal ischemia, decreasing small renal artery wall pressure and vascular permeability; (2) inhibiting vascular smooth muscle cell hypertrophy and reducing extracellular matrix production; (3) affecting the affinity of renal vasopressin receptors; (4) reducing the degradation of bradykinin, which (4) reduce the degradation of bradykinin, which has an antiproliferative and vascular tone improving effect; (5) elevate serum potassium levels, a high potassium diet is known to reduce the permeability of the vascular endothelium, inhibit the adhesion of macrophages to the vascular endothelium, and reduce the damage to the vascular endothelium. ACEI should be noted in the use of renal vascular malignant hypertension should be prohibited, secondary to renal parenchymal lesions renal function has been impaired, blood creatinine levels of 40-50mg/ L L or higher should also be prohibited. In patients with hypovolemic state, ACEI can lead to hypotension, so such patients should be treated with active volume expansion at the same time.