Management of hypertension 2015 georgia chapter acp scientific meeting. Department of veterans affairs singledrug therapy of. B start one drug, then add a second drug before achieving max dose of first c begin 2 drugs at same time, as separate pills or combination pill. The aha is launching a new initiative that elevates awareness and adoption of ahas 2017 hypertension clinical guidelines. Review article treatment of systemic hypertension wilbert s aronow from the cardiology division, department of medicine, new york medical college, valhalla, new york, usa. Hypertension medication treatment protocol1 this document is not intended as a substitute for the medical advice of a physician. Community pharmacists and medication therapy management. Drug therapy for hypertension ch 16 flashcards quizlet. Antihypertensive drug therapy for mild to moderate. Hypertension medication treatment protocol1 american medical. Blood pressure bp thresholds and recommendations for treatment and followup. Get a printable copy pdf file of the complete article 564k, or click on a.
Collaborative practice agreements to enable collaborative drug therapy management. The therapeutic goal is to achieve and maintain a diastolic pressure of less than 90 mm hg with minimal adverse effects. Antihypertensives are a class of drugs that are used to treat hypertension high blood pressure. Antihypertensive drugs are often used in the belief that lowering blood pressure will prevent progression to more severe disease, and thereby improve outcome.
Click here to obtain permission for combining psychosocial and drug therapy. Diuretics thiazide, loop, and potassiumsparing diuretics. Nondrug treatment of hypertension annals of internal. Many professionaldirected programs have been studied to enhance the implementation of various innovations, with a median absolute risk. Implementation of adherence support for patients with. Blood pressure goal for patients with hypertension 5. Drugs of choice in the treatment of hypertension therapeutics.
Hypertension can also be caused by other medical conditions, such as thyroid disease or chronic kidney disease. The department of veterans affairs cooperative study group on. Intravenous antihypertensive drugs for treatment of hypertensive. General considerations the majority of functional alterations resulting from prolonged or severe hypertension stem from damage to three important vascular beds, the brain, the heart, and the kidneys. Drug therapy can lower the blood pressure levels of most hypertensive patients. Uncontrolled high blood pressure bp can lead to heart attack, stroke, heart failure and other serious life threats. Drug therapy of hypertension, edema, and disorders of. Learn vocabulary, terms, and more with flashcards, games, and other study tools. Hypertension mtm data set medication therapy management. Medication therapy management mtm is a distinct service or group of services provided by health care providers, including pharmacists, to ensure the best therapeutic outcomes for patients. If patient is hypotensive when standing but has mild hypertension when seated, pharmacologic treatment may cause more harm than good. Nonsteroidal antiinflammatory drug nsaid therapy in. Links to pubmed are also available for selected references. Discuss the nonpharmacological options for treating hypertension and its affect on blood.
Pdf hypertension, known as a silent killer is widely prevalent and a major risk factor for cardiovascular diseases. Recent evidence on drug therapy of mild to moderate. Initial combination therapy is recommended if bp is greater than 2010mm hg above goal at blood pressure goal. This pdf file on the pharmacological management of hypertension was written by the pharmacology opencourseware initiative at harvard medical school mit. The average blood pressure fall with treatment in trials using low doses of just one drug 79. Uptodate, electronic clinical resource tool for physicians and patients that provides information on adult primary care and internal medicine, allergy and immunology, cardiovascular medicine, emergency medicine, endocrinology and diabetes, family medicine, gastroenterology and hepatology, hematology, infectious diseases, nephrology and hypertension, neurology. Blood pressure components, risk, and comorbidities of hypertension 10. Hypertension guideline resources american heart association. Our comprehensive guide to the management of chronic noncancer pain. Mild to moderate hypertension during pregnancy is common. A read is counted each time someone views a publication summary such as the title, abstract, and list of authors, clicks on a figure, or views or downloads the fulltext. Coexistence of hypertension and related chronic conditions 11. Evidence suggests that reduction of the blood pressure by 5 mmhg can decrease the risk of stroke by 34%, of ischaemic heart disease by 21%, and reduce.
The methods available for the reduction of the blood pressure level in arterial hypertension are outlined. Antihypertensive therapy seeks to prevent the complications of high blood pressure, such as stroke and myocardial infarction. Laboratory tests routine tests electrocardiogram urinalysis blood glucose, and hematocrit serum potassium, creatinine, or the corresponding estimated gfr, and calcium lipid profile, after 9 to 12hour fast, that includes highdensity and lowdensity lipoprotein cholesterol, and triglycerides optional. Choice of drug therapy in primary essential hypertension. Abstract alterations in the composition of the diet that are either known to influence or suspected of influencing hypertension and its treatment were discussed. Jnc 8 hypertension guideline algorithm lifestyle changes. Jnc 8 hypertension guideline algorithm initial drugs of. No endorsement is implied or intended by the american medical association of any thirdparty organization, product, drug or service. Our approach to assessing medications in older adults pain management. Learn about special agreements between pharmacists and care providers on patient drug therapy. Because blood pressure medications may make patients feel worse than the disorder of hypertension itself, nonadherence is a likely problem.
Hypertension may also be a side effect of certain medications, such as overthecounter cold medications and oral contraceptives and other hormone drugs. A comparison of six antihypertensive agents with placebo. In patients without preexisting hypertension receiving chronic nsaid therapy, the average increases in systolic and diastolic bp are around 2. Start studying drug therapy for hypertension ch 16. Many clinicians consider a sufficiently high risk of stroke to be the clearest indication for pharmacological therapy of patients with mild to moderate hypertension. Multiple factors involved in the ethiopathogenesis of hypertension requires therapy to be complex and according to the values of blood pressure and extent of the disease. Effective blood pressure reduction decreases considerably the mortality of patients with g. Objectives to assess the effects of antihypertensive drug treatments for women with mild to moderate hypertension during pregnancy. Population with ckd, initial or addon therapy should include and acei or arb to improve kidney outcomes regardless of race or diabetes. Implementation of innovations into routine healthcare delivery does not usually happen easily or completely. The rationale is derived from several recent overviews or metaanalyses of data from randomized trials. Translation and other rights for information on how to request permission to translate our work and for any other rights related query please click here.
Hypertension highlights 2017 health metrics american heart. Hypertension drug therapy authorstream presentation. Full text full text is available as a scanned copy of the original print version. The treatment of patients with established diastolic blood pressures between 90 and 104 mm hg determined from three separate readings.
If nondrug therapy is strictly adhered, one can prevent cases of prehypertension from progressing to hypertension stage and one can reduce or stop the medications in grade 1 mild hypertension. This document is not intended as a substitute for the medical advice of a physician. Managing hypertension using combination therapy american. Zvara, md antiischemic drug therapy antiischemic drug therapy during anesthesia is indicated whenever evidence of myocardial ischemia exists. Every patient of hypertension from the stage of prehypertension to grade 2 hypertension should follow nondrug therapy.
Over 240 pages of frequently updated charts gerirxfiles. Nondrug therapy in prevention and control of hypertension. Get a printable copy pdf file of the complete article 442k, or click on a. Optimizing hypertension control by karissa kim, pharmd. Describe the five core elements of medication therapy management. The agents now in use are usually better tolerated and more effective than many of those available a few years ago. When hypertension becomes sufficiently severe andor is sustained for an adequate period of time, this in itself can produce the vascular deterioration that occurs in. Physical therapy physical therapy is most appropriate in the first and second stage of the disease. Prehypertension at diagnosis drug treatment not recommended stage 1 hypertension at diagnosis consider at or before 6 months of lifestyle modifications if bp goals unmet stage 2 hypertension at diagnosis at diagnosis 1 for frail elderly patients, standing blood pressure measurements should be considered before initiating drug treatment. It seems probable that there is a close relationship between. Choice of drug therapy in primary essential hypertension uptodate. Prevention of complications of hypertension requires the lowering of blood pressure. Drug therapy of hypertension, edema, and disorders of sodium and water balance.
Combination therapy is treatment with two or more agents administered separately or in a fixeddose combination pill and is required by most patients with hypertension to reach target blood. Evidence about the effectiveness, mode of action, safety, and patient acceptance of the various nondrug. There is general agreement as to which antihypertensive drugs are appropriate for initial therapy in most patients with hypertension. Get a printable copy pdf file of the complete article 1.
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