Hypertension Medications
FAQs on First-Line BP Meds
As a clinical pharmacist, you often encounter questions about choosing blood pressure medications for the initial treatment of uncomplicated hypertension. We know to turn to an ACEI or ARB , calcium channel blocker (CCB) , or thiazide first, CV benefits seem similar overall. But be ready with answers to common questions about nuances... …
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Hypertension Medications
Treat HYPERtension more aggressively in BLACK patients
As a clinical pharmacist, you will be asked more how to treat hypertension in black patients. There's controversy about whether hypertension should be treated more aggressively in black patients than in other races. Over 40% of black adults have hypertension . They also have higher BPs than whites and therefore a higher risk of complications. Now some experts…
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Hypertension
How to treat MILD hypertension
As a cardiovascular pharmacist, you will hear debate about when to start drugs in patients with MILD hypertension, systolic blood pressure (BP) 140 to 159 mmHg or diastolic 90 to 99 mmHg. The latest analysis questions whether BP drugs benefit stage 1 or mild hypertension. It suggests that only one cardiovascular (CV) event is prevented for ever…
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Pain Management
Is it okay for HYPERtensive patients to take NSAIDs?
Is it okay for patients with hypertension to take NSAIDs e.g., ibuprofen, celecoxib, etc? ― Many can, but you need to be careful... On average, NSAIDs increase blood pressure (BP) by around 5 mmHg in patients with hypertension, but some patients are more susceptible than others. Elevations are more likely in the elderly, obese men and patients with diabetes ,…
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Hypertension Medications
Managing hypertension in older adults (60 years or older)
Lowering systolic blood pressure (BP) can benefit even very old patients with hypertension (reducing CV events, heart failure , and death). But older adults may be at higher risk for more side effects from antihypertensive medications, such as dizziness, electrolyte problems, and bumps in serum creatinine. Use the same general approach to manage hypertension in all …
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Hypertension Medications
Recommend the right antihypertensive combination for hypertension
Many patients with uncomplicated hypertension will need two or more medications to reach blood pressure (BP) goals. Comorbidities often drive medication combination choices, such as an angiotensin converting enzyme inhibitors (ACEI) plus beta-blocker in some patients with heart failure or after a heart attack. Emphasize lifestyle changes, assess adherence and check …
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Hypertension Medications
Management of severe hypertension in adults
Overview ― Severe hypertension can be classified into Hypertensive Emergency and Hypertensive Urgency . In Hypertensive Emergency, BP > 180/120 mmHg with target organ damage (new or worsening). Examples include encephalopathy, intracerebral hemorrhage, ischemic stroke, unstable angina, myocardial infarction, left ventricular failure with pulmonary edema, aortic …
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Hypertension
Be ready to manage patients with very high blood pressure
What should you do when patients report a very high blood pressure (BP) reading on a home monitor or pharmacy? Don't automatically refer to the emergency department (ED) for a blood pressure above 180/120 mmHg. Advise promptly rechecking BP, and ensure proper technique, sit quietly for 5 minutes, appropriate cuff size, feet on the floor, etc. And shift the foc…
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Type-2 Diabetes
Blood pressure goals and medications for patients with diabetes
All pharmacists hear continued debate about how to manage hypertension in patients with diabetes. The recent American College of Cardiology and American Heart Association guidelines recommend a blood pressure goal of less than 130/80 mmHg in patients across the board. Years ago, many of us were also taught this goal for patients with diabetes . But the American Di…
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