Background: Atherosclerotic renal artery stenosis is an important secondary cause of resistant hypertension. Although medical therapy remains first-line treatment, renal artery stenting may benefit selected patients with refractory hypertension, recurrent pulmonary edema, or progressive renal dysfunction.

Objective: To evaluate the effect of renal artery stenting on blood pressure control, antihypertensive medication burden, and renal function.

Methods: A prospective observational study was conducted among 186 patients with significant renal artery stenosis undergoing stent implantation. Blood pressure, renal function, and medication use were assessed at baseline, 1 month, 6 months, and 12 months.

Results: Mean systolic blood pressure decreased from 168.4±18.6 mmHg at baseline to 142.7±16.2 mmHg at 12 months. Mean diastolic pressure decreased from 94.8±10.5 mmHg to 82.3±8.9 mmHg. The average number of antihypertensive drugs decreased from 3.8±1.1 to 2.6±1.0. Renal function remained stable in most patients. Greater benefit was observed in patients with resistant hypertension and bilateral renal artery disease.

Conclusion: Renal artery stenting may improve blood pressure control and reduce medication burden in carefully selected patients. Routine stenting for all patients with renal artery stenosis is not supported; individualized patient selection is essential.