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This article explores the relationship between hypertension and chronic kidney disease (CKD), and examines lifestyle modification and medication management. About one in three U.S. adults has high blood pressure, and despite this high occurrence, only onethird of patients are actually treated to a goal blood pressure. Reasons for this vary, but can include ineffective patient teaching, lack of understanding, poor lifestyle modifica - tions, sub-optimal treatment adherence, limited access to health care, or failure of healthcare providers to treat hypertension aggressively. There is a clear relationship between hypertension and CKD. Studies focusing on hypertension and CKD have shown that optimal blood pressure control can slow the rate of renal function impairment, regardless of the underlying kidney disease. Medication self-management, lifestyle mod - ifications, and factors that contribute to non-adherence should be consistently addressed while maintaining an understanding of personal and cultural beliefs.
According to recent estimates by the American Heart Association, one in three U.S. adults has high blood pressure (Appel et al., 20 06). Approximately 50 million individuals in the U.S. and one billion individuals worldwide have hypertension (Appel et al., 20 06). Incidence rates are a direct result of missed diagnosis due to hypertension having few accompanying symptoms. Despite the high incidence, only one-third of patients are actually treated to a goal blood pressure (Alexander, 20 06). Reasons for this may vary but can include ineffective patient teaching, lack of understanding, poor lifestyle modifications, sub-optimal treatment adherence, limited access to health care, or failure of healthcare providers to treat hypertension aggressively. The specific physiologic cause of an individual's high blood pressure can also be unknown. Potential factors can include race (higher incidence in African Americans), age (hypertension increases with age), obesity, lack of exercise, excessive alcohol use, high dietary salt intake, oral contraceptives, gender, family history, and other diseases, such as chronic kidney disease (CKD) (Alexander, 20 06).
An estimated 26 million Americans (one of every six adults) live with CKD. (Burrows & Muller, 2007). High-risk groups include those with diabetes mellitus, hypertension, and family history of kidney disease. The prevalence of CKD is particularly high in older adults, and these patients are often at an increased risk for cardiovascular disease (CVD) ( Schiffrin, Lipman, & Mann, 20 07). The relationship between...