Foundations for Improving Hypertension Management

A MEDS Ed seminar

This session of CareOregon Pharmacy’s MEDS Ed program focuses on basic, practical methods to promote better blood pressure control and chronic kidney disease management, co-morbidities.

• Cardiovascular mortality risk doubles with each 20/10 mmHg increase in blood pressure: Part 1 – 7:35  
• Initial drug therapy guidance: Part 1 – 22:38
• Avoid combining NSAIDs with ACEi/ARBs due to resulting significant decrease in glomerular perfusion/GFR: Part 1 – 40:26
• A patient with CKD is 100x more likely to die than ever reach ESRD – usually of cardiovascular disease: Part 1 – 44:13  

• Resistant hypertension (12-15% of all patients with hypertension) further increases the risk of developing CAD, heart failure, stroke and all cause mortality: Part 2 – 6:55
• Continue to encourage lifestyle modification even as hypertension is being medically managed; weight reduction provides the largest SBP reduction rate: Part 2 – 15:45
• Optimize 3 drug regimen when treating resistant hypertension – RAS blocker (ACEi/ARB), CCB, and diuretic appropriate for kidney function (thiazide GFR > 30 – use chlorthalidone, and loops diuretic GFR <30): Part 2 – 18:12
• Don’t forget about spironolactone!: Part 2 – 22:00

• Perspective on avoiding Atenolol and Metoprolol: Part 3 – 3:37