Acoustic energy is delivered to innervated vascular that contributes to renal sympathetic nerve activity, such as innervated tissue of the renal artery and abdominal aorta. Focused acoustic energy is delivered via an intravascular device of sufficient power to ablate innervated renal or aortal tissue. Focused acoustic energy may be delivered via an intravascular or extracorporeal device to image and locate target innervated renal or aortal tissue. Intravascular, extravascular, or transvascular focused ultrasound devices provide for high precision denervation of innervated vascular to terminate renal sympathetic nerve activity.