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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Pediatric
Suggest lifestyle changes first for HYPERtensive kids
As a clinical pharmacist, you will hear buzz about how to treat hypertension in children and adolescents, due to Hypertension guidelines. About 2% to 4% of children in have hypertension . Kids are considered hypertensive if their BP is at the 95th percentile or higher for their age, sex, and height, measured on at least 3 separate occasions. …
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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 Medications
How to choose CCB for your patient
As a clinical pharmacist, there’s often confusion about how to choose a calcium channel blocker (CCB) due to the laundry list of products and uses. Think of dihydropyridine CCBs (amlodipine, nifedipine, etc) as more potent vasodilators, but they can bump up heart rate. NONdihydropyridines (diltiazem, verapamil) slow heart rate. Preferred choice…
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Myocardial Infarction
Aspirin for PRIMARY prevention is different story
As a cardiovascular pharmacist, you will be asked whether "an aspirin a day" is still good for the heart, based on new U.S. Preventive Services Task Force recommendations. Help patients sort out the facts. This is a case of guidance catching up with the evidence... Recommend aspirin 81 mg/day for SECONDARY prevention , such as…
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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
Bedtime hypertension treatment and improving cardiovascular outcomes
There will be renewed debate about whether taking blood pressure medications at bedtime improves CV outcomes. The idea behind this “chronotherapy” is to combat the morning blood pressure rise or help patients whose blood pressure doesn’t “dip” at night like it should. Now evidence suggests that cardiovascular risk is lower if patients take at least one of their once-…
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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
Overview of hypertension
Introduction ― Hypertension is defined as persistently elevated arterial blood pressure (BP) or usual office blood pressure of 140/90 mm Hg or higher, but recent U.S. guidelines have changed the definition to 130/80. Normal blood pressure (BP) in adults: systolic BP < 120 mmHg and diastolic < 80 mmHg. According to NICE guidelines, hypertension (HTN) can be cla…
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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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