Ultrasound Wave Therapy for Post-stenotic Microvascular Remodeling

Inclusion Criteria * Patients are between ages 40 and 80 years old. * Patients with hypertension (Systolic BP\> 155 mm Hg) and/or requirement for two or more antihypertensive medications for more than 4 weeks, no restrictions on antihypertensive agents, although loop diuretics may be changed to diluting site agents (e.g. hydrochlorothiazide, indapamide, metolazone) for two weeks prior to study. * Patients have serum creatinine ≤2.2 mg/dL. * Patients have no contraindications to angiography: severe contrast allergy. * Patients have no contraindications to no-contrast MR evaluations: e.g. pacemaker or magnetically active metal fragments, claustrophobia. * Patients have the ability to comply with protocol * Patients are competent and able to provide written informed consent Exclusion Criteria * Patient have serum creatinine \>2.2 mg/dL * ARAS in a solitary kidney * Patients have clinically significant medical conditions within the six months before SWT treatment: e.g. myocardial infarction, congestive heart failure, stroke, that would, in the opinion of the investigators, compromise the safety of the patient. * Uncontrolled hypertension (Systolic BP \>180 mmHg despite therapy). * Pacemaker, implantable defibrillator or other contraindication to MRI * Inability to comply with breath-hold for 20 seconds * Any active malignancy and undergoing therapy * Patients are pregnant. * Kidney or ureteric stone that may affect the effect of SWT. * Another known acute or chronic kidney dis…