Nov 12, 2018

Hypertension is so common that treating it is the most frequent reason for office visits of adults to healthcare professionals in the United States. Approximately half of patients with hypertension don’t have good blood pressure control, and treating those patients can be complex and require multiple drugs. Numerous trials contributed to the new ACC/AHA meta-analysis, which tells clinicians that the NEW hypertension cutoff is 130/80. Getting patients to this number significantly lowers the risk of composite major CVD (cardio-vascular disease), events, and fatal/non-fatal stroke. The decreased risk for fatal/non-fatal myocardial infarction was borderline insignificant, but observational data tells us that HTN contributes to CVD. Measuring BP in the office generally leads to readings that are 5-10 mm Hg higher than those obtained at home. Since hypertension is now defined by repeated home blood pressure readings of greater than 130/80, you need reliable readings without a white coat in the room. Recommend a reliable home BP monitor like Omron, and have patients keep a record of readings. Treatment is multifactorial: exercise, Mediterranean diets, weight loss and mediation are all reachable goals. Recommend INSIGHT TIMER, one of the best meditation apps around. Medications work, and we should use them, but spend time to make sure your patient tolerates them, and is willing to take them consistently. Bothersome side effects of these medications contribute to under-treatment of this dangerous disease.