Renal Atherosclerotic Revascularization Evaluation: RAVE Study

Inclusion Criteria: * Systolic blood pressure \> 140 mmHg and/or diastolic blood pressure \> 90 mmHg despite at least 3 antihypertensive medications * Systolic blood pressure \>140 mmHg and/or diastolic blood pressure \> 90 mmHg on two antihypertensives with: a rise in creatinine \> 20% after initiation of an angiotensin-converting enzyme inhibitor (ACEi) or angiotensin receptor blocker (ARB); the sudden onset of hypertension occurring after age 55; hypokalemia or the presence of an abdominal bruit; a history of flash pulmonary edema; or any three of: peripheral vascular disease, coronary artery disease, cerebrovascular disease, smoking, hyperlipidemia, diabetes or male gender. Exclusion Criteria: * Serum creatinine \> 220 umol/L or estimated glomerular filtration rate (GFR) by Cockroft-Gault equation \< 20 ml/min * Patients who are unwilling or unable to give informed consent * Known contraindication to renal revascularization such as anaphylactic allergy to contrast dye * An abdominal aortic aneurysm requiring surgery * A single functioning kidney; a total occlusion of the renal artery or renal artery stenosis due to fibromuscular dysplasia. * Previous revascularization