After 20 Years of Hypertension, a 41-Year-Old Man Finally Stops Blood Pressure Medication
Twenty Years of Hypertension — Medication Could Not Be Stopped
Mark was only 21 years old when he first began taking medication for high blood pressure. At its highest, his blood pressure once reached 170/110 mmHg.
For nearly two decades, medication helped keep his condition under partial control, but his blood pressure remained unstable. Two years earlier, he had undergone balloon angioplasty for narrowing of the left renal artery, a procedure designed to open the narrowed vessel.
After that procedure, his blood pressure improved to some extent, but he still needed daily medication. During a recent follow-up examination, however, doctors found that his left renal artery had become severely narrowed again — this time reaching approximately 90% stenosis.
At the same time, Mark was also found to have mild coronary artery narrowing and type 2 diabetes. He then came to see Dr. Ke from the Department of Cardiology for further evaluation.
Blood pressure up to 170/110 mmHg · Medication remained necessary · Left renal artery narrowed by 90%
The Diagnosis — Renal Artery Stenosis Triggering Secondary Hypertension
After admission, Dr. Ke and the team performed combined coronary and renal artery angiography. The examination showed that the opening of Mark's left renal artery was narrowed by approximately 90%, severely restricting blood flow to the kidney.
Dr. Ke explained that the kidneys play a major role in blood pressure regulation. When the renal artery becomes narrowed and the kidney receives insufficient blood supply, the body activates an emergency response known as the renin-angiotensin-aldosterone system, or RAAS.
"When the kidney senses reduced blood flow, the body may respond by tightening blood vessels and retaining water and sodium. This can drive blood pressure higher and make ordinary blood pressure medication less effective."
Mark's condition was a type of secondary hypertension known as renovascular hypertension. In this situation, if the narrowing of the renal artery is not corrected, blood pressure may remain difficult to control and kidney function may also be affected over time.
The Treatment — One Stent to Reopen the Blood Pressure 'Switch'
Dr. Ke and the cardiology team performed renal artery stent implantation for Mark. The procedure was carried out through radial artery access at the wrist rather than through the thigh, allowing a less invasive approach and faster recovery.
- Left renal artery narrowed by 90%
- Blood flow to the kidney was severely restricted
- RAAS activation contributed to persistent hypertension
- Blood pressure remained difficult to stabilize
- Long-term medication was still required
- Radial artery puncture through the wrist
- Balloon pre-dilation of the narrowed segment
- Precise placement of a 7.0 × 18 mm renal artery stent
- Post-procedure angiography confirmed good stent expansion
- Renal blood flow was successfully restored
The operation went smoothly, and Mark did not experience obvious discomfort. Immediately after the procedure, the sheath was removed, and a radial artery compression device was used for hemostasis.
"For this type of secondary hypertension, treating the underlying cause can be more effective than simply increasing medication."
The Result — Blood Pressure Normalized and Medication Was Stopped
After the procedure, Mark's blood pressure gradually decreased and became stable. Under close medical monitoring, he was able to stop all antihypertensive medication, while his blood pressure remained within the normal range.
Dr. Ke explained that once the narrowed renal artery was reopened, the kidney's blood supply improved. As the kidney was no longer in a state of ischemia, the abnormal activation of the RAAS system was reduced, allowing blood pressure to return toward normal.
Nearly 20 years of hypertension. Blood pressure remained unstable despite long-term medication.
A renal artery stent was placed precisely to reopen the severely narrowed vessel and restore blood flow.
Blood pressure gradually normalized, and antihypertensive medication was stopped under medical supervision.
"After the renal artery stenosis was corrected, the kidney's ischemic state improved, and the abnormal blood pressure-raising system was effectively switched off."
— Dr. Ke
For Mark, the result was unexpected and deeply meaningful. After taking medication for nearly 20 years, he had not imagined that one stent could help him finally stop blood pressure medication.
"I had been taking blood pressure medication for 20 years. I never expected that one stent could help me stop it."
— Mark
Mark's story is a reminder that not all hypertension is the same. When high blood pressure appears at a young age, remains difficult to control, or requires multiple medications, secondary causes such as renal artery stenosis should be considered and evaluated by specialists.