Description
Inclusion Criteria:
- * Living kidney donors who underwent a living kidney donation at least 5 months ago but not more than 12 months
- * Age ≥18 years old
- * Agree to perform the procedure as per study protocol (Table 1)
- * Living kidney donors with an average sitting SBP \<160 mmHg at 5-month post-donation measured by automatic office blood pressure (AOBP)
- * Able to sign informed consent
- * Able to attend all research visits
- * Woman using birth control methods other than hormonal contraception
Exclusion Criteria:
- * History of previous cardiovascular (CV) events including acute MI, HF, and stroke
- * Symptomatic heart failure within 5 months after living kidney donation or left ventricular ejection fraction (by any method) \<35%
- * CV event or procedure or hospitalization for hypertensive-related disorders within 5 months after living kidney donation
- * Diagnosed with HTN or on antihypertensive medication(s) before living kidney donation
- * Patients who are supposed to take BP lowering medications for reasons other than BP control but do not take those medications or take them with in appropriate doses
- * Arm circumference is too small or large to allow accurate BP measurement with available 24-h ABPM machines.
- * An average standing SBP ≥160 mmHg at 5-month post-donation measured by automatic office blood pressure (AOBP)
- * Albuminuria that equals or is equivalent to 1 g per day by using spot urinary albumin per urine creatinine ratio (UACR) or 24-hour urinary albumin excretion rate by a 24-hour urine collection within 5 months post-donation
- * Advanced kidney function defined by estimated glomerular filtration rate (eGFR) by using Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation22 of \<20 ml/min/1.73m2 or requiring dialysis after living kidney donation
- * Drink coffee \> two 8-ounce (237 mL) cup a day or equivalence
- * Drinks alcohol \>3 drinks/day or \>30 ml/day
- * Smoking cigarette ≥10 cigarettes/day
- * Take Nonsteroidal anti-inflammatory drugs (NSAIDS)
- * Use hormone replacement therapy or oral contraceptives
- * Pregnancy, currently trying to become pregnant
- * Using birth control pills
- * A medical condition likely to limit survival to less than 2 years
- * Any factors that are likely to limit adherence to interventions. For example,
- * Living kidney donors who cannot come to follow up regularly per study protocol to logistically collect data from enrolled participants.
- * Active alcohol or substance abuse within the last 5 months of living kidney donation
- * Plans to move outside the clinic catchment area in the next 4 months without the ability to transfer to come to follow up at SPLID study site.
- * Significant history of poor adherences with medications or attendance at clinic visits
- * Significant concerns about participation in the study from spouse, significant other, or family members
- * Lack of support from primary health care provider
- * Residence too far from the study clinic site such that transportation is a barrier including persons who require transportation assistance provided by the SPLID clinic funds for screening or randomization visits
- * Residence in a nursing home or an assisted living
- * Clinical dementia with or without treatment with medications and cognitively unable to follow the protocol
- * Other medical, psychiatric, or behavioral factors that may interfere with study participation or the ability to follow the intervention protocol
- * Inability to obtain informed consent from participant
- * Living in the same household as an already randomized SPLID participant
Ages Eligible for Study:
18 Years to N/A (ADULT, OLDER_ADULT)
Sexes Eligible for Study: ALL
Accepts Healthy Volunteers:
Yes