Blood Pressure (BP) control is a common indication for renal artery revascularization in patients with atherosclerotic renal artery stenosis (RAS). The purpose of this study is to evaluate BP control among CORAL participants over time.

Methods: Participants were randomized to stent or no stent. Renin angiotensin system inhibition is first-line therapy with add-on drugs including a dihydropyridine calcium antagonist, and or a thiazide diuretic provided, in addition to step-wise recommendation for additional anti-hypertensives. The treatment protocol specifies a blood pressure (BP) goal <140/90 mm Hg, or <130/80 mm Hg in the setting of Chronic Kidney Disease (CKD), defined as eGFR < 60ml/min, or diabetes (DM).

Results: The average age at study entry was 69±9 with 50% female. In the cohort 62% had either DM or CKD, with 34% diabetic and 58% CKD. Bilateral RAS or stenosis in an artery to a solitary kidney was identified in 149/931,16% and prevalent cardiovascular disease (CVD) in 611/890, 69%. Data on BP response by drug class will be presented.

Conclusions: Anti-hypertensive treatment of patients with atherosclerotic RAS using step-wise care including a renin-angiotensin inhibitor, with or without a long-acting calcium antagonist, thiazide diuretic or other medications results in goal BP attainment in 93% of patients without CKD or DM, and 80% with CKD or DM at 2-year follow-up.