1. Male or female subjects aged 18 years or older.
2. Documented history of hypertension and currently taking two or more antihypertensive medications with uncontrolled blood pressure (defined as daytime systolic BP ≥135 mmHg and/or diastolic BP ≥85 mmHg on optimized medication therapy, as measured by baseline ABPM).
3. Clinical evidence suggestive of renal artery stenosis, and scheduled for renal angiography.
4. Willing and able to provide written informed consent prior to initiation of any study-related procedures, and willing to comply with all study requirements.
5. Renal angiography shows ≥70% to \<99% stenosis in at least one main renal artery with a reference vessel diameter of ≥4.0 mm.
You may not be if
1. Systolic BP ≥200 mmHg and/or diastolic BP ≥120 mmHg on the day of randomization.
2. Suspected non-atherosclerotic causes of RAS, such as fibromuscular dysplasia or large-vessel vasculitis.
3. Pregnant or breastfeeding women.
4. Participation in another clinical trial that, in the investigator's opinion, could interfere with this study.
5. Stroke or TIA within 3 months and known ≥70% carotid artery stenosis.
6. Major surgery, myocardial infarction, or any interventional procedure within the past 30 days.
7. Known LVEF \<30%.
8. Life expectancy ≤1 year.
9. Known allergy to contrast media or to any of the following medications: aspirin, clopidogrel.
10. History of renal transplantation.
11. Prior renal artery stenting or bypass surgery.
12. Affected kidney length \<8 cm on Doppler ultrasound.
13. Serum creatinine \>3.0 mg/dL (265.2 μmol/L) at baseline visit (measured by local laboratory).
14. Reference vessel diameter \<4 mm or \>8 mm on angiography.
Clareo Health | A Placebo-controlled Trial of Fractional Flow Reserve-guided Percutaneous Renal Artery Stenting Among Atherosclerosis Renal-vascular Hypertension Patients
