Although the prevalence of renovascular hypertension (RVH) is rare (< 1) in patients with mild hypertension, it appears to be present in 10 to 40 of those with refractory hypertension and in those with widespread atherosclerotic disease, particularly peripheral arterial disease. Its clustering with atherosclerotic disease elsewhere gave rise to the practice of treating the renal artery as one would treat coronary vessels (i.e., with angioplasty or stenting). In fact, employing these techniques to better control blood pressure and preserve kidney function was rather common until recently. When the question arises about whether or not to stent, consider these guidelines: