Background and Rationale Cardiovascular disease is highly prevalent in the kidney transplant population, accounting for approximately 40% of all deaths and significant morbidity. The morbidity and mortality experienced by kidney transplant recipients results from an excess of pre-transplant risk factors that are exacerbated by kidney transplantation along with the development of novel risk factors. Hypertension (HTN) is the most consistent cardiovascular disease risk factor in transplant recipients. The majority of patients with kidney failure have HTN and close to 30,000 individuals annually have HTN as the primary cause of kidney failure. A number of immunosuppressive medications exacerbate HTN after transplantation. Further, there is a clear effect of declining allograft function on cardiovascular disease risk.