Hypertension as a Risk Factor for Renal Impairment in General Population: A Cross-Sectional Survey Through the Italian Pharmacy Network

Background: The changing age structure of the population has highlighted the phenomenon of chronic diseases, such as arterial hypertension (AH) and chronic kidney disease (CKD). Therefore we have designed cross-sectional survey through the pharmacy network in order to assess risk factors, in particular AH for renal impairment in general population of northeastern area of Italy (Vicenza). Objectives: The main aim of this study was to estimate patients with undiagnosed AH in the area under investigation. In addition, we assessed hypertensive patients that were out of pharmacology therapeutic goal and the knowledge of AH as a risk factor for CKD in general population. Participants, Setting and Measurements: The survey was carried out between October 2014 and February 2015 by the Department of Nephrology, Dialysis and Transplantation, St. Bortolo Hospital (Vicenza, IT) in collaboration with community-pharmacists (CP). 35 CP participated without financial compensation, based on commitment and willingness. The survey was conducted on general population (n = 2036): 94.4% Caucasian and 5.6%, non-Caucasian, age ≥18 years old, 39.1% male and 60.9% female. The survey was based on risk factors for CKD, the population’s knowledge of AH as risk factor for CKD, and included a single measurement of blood pressure (BP). Results: 28.61% of participants were undiagnosed hypertensive. Furthermore, 57.6% of the patients undergoing antihypertensive pharmacology treatment did not reach the therapeutic goal. The BP measurement differed among age (p < 0.01) but no in gender. A large percentage of population did not recognize AH as a risk factor for CKD (46.3%). The latter was statistically significant in both age and gender (p < 0.01). Conclusion: AH as a risk factor for renal impairment demands more attention in the primary care setting, both in patients undergoing antihypertensive pharmacology treatment and in general population. Additional work is needed to determine factors, which contribute to the unacceptable high antihypertensive treatment failure. Screening programs should be periodically performed in the general care setting in order to identify undiagnosed hypertensive patients. Furthermore, the awareness of AH as a risk factor for development of CKD should be raised to obtain high compliance in prevention and pharmacology treatment.