ITEMS IN AFP WITH KEYWORD:
The American College of Physicians (ACP) and American Academy of Family Physicians (AAFP) have made recommendations for all clinicians to treat hypertension in persons 60 years and older, based on the benefits and harms of higher (less than 150 mm Hg) and lower (140 mm Hg or less) systolic BP targets.
A high standard must be met when guidelines recommend lifelong preventive medications, knowing that at best, a small minority of patients will benefit and that all are risking harm.
Severely elevated blood pressure without symptoms of target organ injury can often be managed in the outpatient setting. A gradual lowering of blood pressure over several days to weeks is recommended over aggressive reduction.
It seems that rapid treatment of patients with hypertensive urgency is unsuccessful and unnecessary. In this study of almost 60,000 patients, 80% did not have controlled blood pressure (less than 140/90 mm Hg) after one month of treatment, including patients who were hospitalized. On the other hand,...
Oct 15, 2016 Issue
ACE Inhibitors or ARBs to Prevent CKD in Patients with Microalbuminuria [FPIN's Clinical Inquiries]
ACE inhibitors reduce the risk of progression to macroalbuminuria in normotensive patients with microalbuminuria and type 1 diabetes mellitus.
Although most recent practice guidelines have relaxed the blood pressure goals for patients with diabetes, there are still a few holdouts that suggest aggressive treatment. This analysis shows that the ideal range for hypertension control in patients with diabetes is between 140 and 150 mm Hg; highe...
Patients with hypertension who are treated intensively are less likely to have major cardiovascular events, stroke, or progression of albuminuria or retinopathy than those treated less intensively, but intensive lowering had no meaningful effect on myocardial infarctions, heart failure, or mortality.
These guidelines from the American Heart Association (AHA) and the American Thoracic Society (ATS) address evaluation and treatment of pediatric pulmonary hypertension, including diagnosis, pharmacotherapy, and outpatient treatment recommendations.
A 55-year-old black man presents for a blood pressure evaluation. He is trying to be more physically active and health conscious but has not seen a physician for five years. He takes no medications, has no concerns, and his physical examination findings are unremarkable. According to the blood press...
In this group of older patients (mean age = 68 years) who do not have diabetes but are at high risk of cardiovascular disease, a more aggressive systolic BP target of 120 mm Hg instead of 140 mm Hg led to benefits (lower all-cause mortality, lower cardiovascular mortality, less heart failure), but a...