© Springer International Publishing AG 2017 233
A. Covic et al. (eds.), Resistant Hypertension in Chronic Kidney Disease,
DOI 10.1007/978-3-319-56827-0_15
Chapter 15
Public Health Efforts for Earlier Resistant
Hypertension Diagnosis, Reduction of Salt
Content in Food, Promotion of the Use
of Polypills to Facilitate Better Adherence,
and Reimbursement Policies
Nursen Keles, Yusuf Yilmaz, and Mustafa Caliskan
Introduction
In the developed and developing world, one in three adults suffers from hypertension,
which is the most common chronic condition that primary care physicians and other
health practitioners deal with.
There are many other risk factors seen in patients alongside hypertension; these
include lipid abnormalities, glucose intolerance or diabetes, a history in the family
of early cardiovascular events, obesity, as well as smoking.
Even though there are well-established approaches to the diagnosis and treat-
ment of the disease, there has been limited success in treating hypertension, and in
many communities less than half of all hypertensive patients have well-controlled
blood pressure [ 1 ].
Resistant Hypertension Definition in Patients with High
Cardiovascular Risk
The Eighth Joint National Committee (JNC 8) has released hypertension guidelines
which recommend the goal of treatment of hypertension to be <140/90 mmHg for
patients with CKD although the American Society of Hypertension (ASH) in
N. Keles, M.D. • Y. Yilmaz, M.D.
Department of Cardiology, Istanbul Medeniyet University, Goztepe
Training and Research Hospital, Istanbul, Turkey
M. Caliskan, Prof (*)
Department of Cardiology, Medeniyet University, Goztepe Training
and Research Hospital, Istanbul, Turkey
e-mail: [email protected]; [email protected]