1855 Tomoda suggests that specific subgroups of patients, including those with severe stenosis or heart failure, may benefit from stenting. In our study, we found no benefit in patients with severe stenoses (≥80% according to investigator evalu-ation) or with global ischemia, and we found no benefit in preventing hospital admissions for heart failure. Approximately 12 to 15% of the patients had heart failure at study entry. Some people, such as those with severe kidney disease or rapidly progressive renal failure, may not have been well represented in the study. Renal-artery stenting may benefit some of the patients de-scribed by Tomoda; however, data are lacking from randomized, controlled clinical trials to support that hypothesis. The results of our study suggest that most patients in stable condition should receive medical therapy regardless of the initial level of kidney function. In reply to Leesar and colleagues: a type II error is possible, but the CORAL study was de-signed to achieve and did achieve adequate power to exclude a meaningful benefit with re-spect to the prevention of clinical events. Leesar et al. ask whether patients with a pressure gradi-ent across the renal-artery stenosis might benefit from renal-artery stenting, as is suggested in several studies that used a surrogate end point, systolic blood pressure, as the outcome. In our study, we found a small but significant reduction in systolic blood pressure of 2 mm Hg favoring stent treatment; this reduction did not translate into a benefit with respect to event-free surviv-al. In our study, we did obtain data on trans-lesional renal-artery pressure gradients, and analyses of these data should be informative about the value of determinations of pressure gradients. With regard to the letter by Mahé and Jaqui-nandi: we considered the renal resistance index as a variable that might be predictive of treat-ment outcomes, and we prospectively included that measure in an analysis involving the ultra-sonographic findings in a subgroup population. However, the renal resistance index has not been proved conclusively to be useful in selecting pa-tients for renal-artery revascularization. 1-3 Zanoli and colleagues report that smaller re-nal arteries (<5.2 mm) and smaller renal-artery lumen diameters (<2.9 mm) are associated with lower glomerular filtration, resistant hyperten-sion, and a higher risk of cardiovascular events among people undergoing coronary angiography. Data are lacking from observational studies to replicate this relationship. If we assume that this relationship will be replicated in future observa-tional studies, the conclusion of our study re-mains that medical therapy appears to work as well as stenting with medical therapy in patients with renal-artery stenosis.