Hypertension Management Update

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Overview

About 75 million Americans 20 years of age or older have hypertension. This number is expected to increase to more than100 million over the next 15 years. Unfortunately, even with many effective treatments and the promotion of clinical guidelines, only 44% of hypertensive adults reach blood pressure targets. High blood pressure is a major risk factor for cardiovascular and kidney disease. Clinical studies have shown that antihypertensive therapy can reduce heart attacks, strokes, and heart failure by 25%, 40%, and 50%, respectively.
Despite the wealth of evidence for the efficacy of various antihypertensive agents, the choice of preferred agents remains hotly debated. The focus has shifted to identification of preferred combinations, since the vast majority of patients require more than one drug to reach blood pressure targets. This issue will review recommendations for initial drug therapy and the current controversies related to specific drug classes. But more importantly, it will discuss approaches to combining antihypertensive agents. Recommendations for lifestyle changes to lower BP such as weight loss, exercise, and diet are also summarized.

Publication Date: Jul-1-10
Expiration Date: Jul-1-13
CE Credit: 1.5 (.15 CEU)
Type of activity: Knowledge-based

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Programs developed by The Rx Consultant are written by health care providers with expertise in the topic area, peer-reviewed, extensively edited, and fact-checked. This development process was created to insure that every program presents information that is current, accurate, relevant to "real world" health care providers, and written in an easy reading, "plain English" style.

Authors

Heather Ulrich, PharmD BCPS, CDE is a clinical pharmacy specialist and diabetes educator at the Veterans Affairs Medical center in Lebanon, Pennsylvania.

Disclosure Statement

Dr. Ulrich reports no financial or personal relationship with any commercial interest producing, marketing, reselling, or distributing a product or service that appears in this issue.

Editorial and Review Board

Editor and CE Administrator Terry M. Baker, PharmD Associate Editor and CE Coordinator Tracy Farnen, PharmD Associate Editors James Chan, PharmD, PhD Pharmacy Quality and Outcomes Coordinator Kaiser Permanente Oakland, CA Associate Clinical Professor School of Pharmacy University of California San Francisco San Francisco, CA Ron Finley, RPh Lecturer Department of Clinical Pharmacy University of California San Francisco San Francisco, CA Associate Member of the UCSF Memory and Aging Center Alzheimer's Research Center Consultant Pharmacist to the Institute on Aging-On Lok Senior Health Institute on Aging Alzheimer's Day Care Center Angie S. Graham, PharmD Drug Information Coordinator Stanford Hospital and Clinics Stanford University Medical Center Stanford, CA Julio R. Lopez, PharmD, FCSHP Chief of Pharmacy Service VA Northern California Health Care System Adjunct Clinical Professor College of Pharmacy Touro University Vallejo, CA Assistant Clinical Professor School of Pharmacy University of California, San Francisco San Francisco, CA

Adjunct Professor Thomas J. Long School of Pharmacy University of the Pacific Stockton, CA Visiting Associate Professor and Lecturer Nursing School Samuel Merritt University Oakland, CA Pamela Mausner, MD Joshua J. Neumiller, PharmD, CDE, CGP, FASCP Assistant Professor Department of Pharmacotherapy College of Pharmacy Washington State University And Elder Services of Spokane Spokane, WA Candy Tsourounis, PharmD Professor of Clinical Pharmacy Medication Outcomes Center Department of Clinical Pharmacy School of Pharmacy University of California, San Francisco San Francisco, CA Senior Editorial Advisor Gerard Hatheway, PharmD, PhD Editorial Advisors Jocelyn Chan, PharmD Belinda M. Danielson, RPh Christopher M. DeSoto, PharmD Cynthia Chan Huang, PharmD, MBA Fred Plageman, PharmD Editorial Advisor and Clinical Practice Consultant for Nurse Practitioners Emily K. Meuleman, RN, C, MS

Accreditation Statements

The Rx Consultant is a publication of Continuing Education Network, Inc.

About the Rx Consultant

The Rx Consultant is a monthly publication dedicated to providing health care professionals with the information they need to educate patients about drugs and manage drug therapy. The reader is responsible for confirming the information presented here and interpreting it in relation to each patient's specific situation before utilizing the information.

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Target Audience

This accredited program is targeted to pharmacists and nurses.

Exam and Credit Statement Procedures

Upon successful completion of this program and the post test (70%), 1.5 hours of continuing education credit will be awarded. To receive credit and your exam score, please complete the exam questions and program evaluation.

Educational Goals and Objectives

At the conclusion of this program, participants will be able to:

1. Discuss current considerations for hypertension management, including recommended lifestyle changes.
2. Provide recommendations for initial antihypertensive therapy based on the stage of hypertension and coexisting conditions. Include current evidence related to the role of beta blockers.
3. Describe combination treatments for hypertension and the rationale behind the use of specific drug combinations.
4. Provide education to patients regarding the use of home blood pressure monitors.