All patients with atheromatous renovascular disease (ARVD) should be considered for treatment with renin–angiotensin blockade (RAB) unless absolutely contraindicated, state the authors of a recent study. Chrysochou et al. analyzed data from 621 individuals with ARVD and found that RAB was well tolerated in most patients receiving it, even in 78% of those with bilateral renal artery stenosis of ≥60% or occlusion. Patients receiving RAB were less likely to die over the 10-year study period than those not receiving such treatment.