Patients destined to progress to ESRD, i.e., the elderly, are a growing segment of the population. Additionally, males and African–Americans with pre-existing hypertension and CKD are also at much higher risk for ESRD [9]. This observation has also been confirmed throughout the developed world: Europe, Asia, Australia, and regions of India and

Africa [4, 5]. The role of hypertension Hypertension is a global problem, and the situation is projected to get worse. It is the major risk factor for development and progression in non-diabetic and diabetic CKD. The world population is getting older, and aging is the most common risk factor for the development of hypertension and diabetes as well as CKD. Nearly 1 billion people worldwide have high blood pressure (defined as >140/90 mmHg), and that number is expected to increase to 1.56 billion people by selleck chemical 2025 [10]. The prevalence of hypertension is predicted to increase by 24% in developed countries and by 80% in developing regions, such as Africa and Latin America. One report noted that 333 million adults in economically developed regions, such as North America and Europe, had high blood pressure in 2000, and an additional 639 million people in developing countries have this condition. In 1999–2006, the

prevalence of hypertension in US adults was 43.4% when defined as >140/90 mmHg, and similar figures have been reported Selleckchem GS-4997 from many Western countries [9]. The rates of hypertension were Selleck GSK2399872A highest in participants who were 60 years or older, i.e., 68–80% versus 25% in those between 20 and 39 years, in non-Hispanic blacks (53%) versus Caucasians (43% versus Mexican–Americans CHIR 99021 (34%). Furthermore, hypertension was more common in individuals with a higher body mass index (BMI) (60% for BMI ≥ 35 vs. 32% for BMI of 23). Slightly more than half of adults with hypertension were aware of their disease in 1999–2004; fewer than half were treated for their hypertension with medications; less than two-thirds

were controlled to <140/90 mmHg with medication [9]. This trend in poor blood pressure control is observed worldwide. The hypertension control rate is substantially less in patients with CKD, particularly those with diabetes and CKD [1, 9]. This is illustrated by the National Kidney Foundation’s (USA) Kidney Early Evaluation Program (KEEP), a US-based health-screening program for individuals at high risk for kidney disease [9]. The prevalence (86.2%), awareness (80.2%) and treatment (70.0%) of hypertension in the screened cohort were high; however, blood pressure control rates were low (13.2%). The proportion of hypertensive patients increased with advancing stages of CKD.