Jun 15, 2018

“Silent killer,” which would be an amazing slasher movie title, is often used to describe hypertension – a disease that causes irreparable harm to the body with few (if any) physical symptoms.

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May 10, 2018

Hypertension, considered a leading risk factor for cardiovascular morbidity and mortality, is poorly managed in our healthcare delivery system today.

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Feb 2, 2018

There is an old adage in the fashion industry that if you wait long enough, everything comes back into style. While that may not be true (yet) for Saturday Night Fever polyester suits, it certainly seems to apply to blood pressure (BP) goals in patients with type 2 diabetes mellitus (T2DM).

Comments: 1
Dec 8, 2017

1. Blood pressure categorizes and terminology have changed…again. The new ACC/AHA/AAPA/ABC/ACPM/ACG/APhA/ASH/ASPC/NMA/PCNA (that's a mouthful!) guidelines for the prevention, detection, evaluation, and treatment of high blood pressure (BP) in adults now have four BP categories:

Comments: 4
Feb 24, 2017

Hypertension affects more than 70% of patients with type 2 diabetes mellitus and further increases the risk of cardiovascular disease in this high risk population.1 While renin angiotensin system (RAS) blockers are clearly indicated in patients with heart failure, chronic kidney disease with proteinuria, and coronary artery disease (CAD), experts have come to different conclusions regarding their role as initial antihypertensive therapy for patients with diabetes (See Table 1).

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Jun 3, 2016

Resistant hypertension (RH) is frequently encountered in primary care practice and often presents a significant clinical challenge because limited evidence-based guidance exists.1 RH is a major cause of cardiovascular disease and death, and has been associated with a 50% increased risk of myocardial infarction, stroke, congestive heart failure, and chronic kidney disease when compared to patients without RH.2,3   The American Heart Association defines RH as uncontrolled

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Apr 4, 2016


Resistant hypertension (RH) is frequently encountered in primary care and a significant clinical challenge.  After a combination of 3 or 4 guideline-recommended treatments have been used, it remains unclear what the next best “add on” treatment for RH should be.  The recently published PATHWAY-2 study provides some evidence.  Read the iForumRx commentary.


Case Presentation:

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Feb 10, 2016

The debate over the intensity of blood pressure (BP) lowering for patients with hypertension has been going on for decades.

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May 17, 2015

Could a commonly prescribed antibiotic, when combined with a renin-angiotensin system inhibitor, lead to sudden death?  Angiotensin converting enzyme inhibitors (ACE-I), angiotensin receptor blockers (ARB), and spironolactone are frequently used in older adults for a variety of indications.

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Jan 27, 2015

The American Heart Association reports that 1 out of 3 adults in the Unites States have high blood pressure and the direct and indirect costs exceeded $50 billion in 2009.

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Nov 4, 2014

Have you ever had difficulty convincing some of your patients that generic medications work just as well as their brand-name counterparts?  While there is little evidence to suggest that generic medications aren’t therapeutically equivalent, a more subtle and perhaps more vexing problem is now emerging.

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Jul 17, 2014

Several foods appear to have a positive impact on blood pressure: dark chocolate, guava fruit, soy, and garlic, to name a few.1-6  They please both the palate and the prescriber.  Most people won’t turn down chocolate and most clinicians won’t turn down the chance to lower blood pressure in a patient with hypertension.  Enter flaxseed (Linum usitatissimum L) — it’s high-fiber, rich in alpha-linolenic acid (ALA), and may be beneficial for a variety of cardiovascular indicat

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Feb 5, 2014

In the United States, nearly 70% of adults are overweight or obese.1  Excess adipose tissue increases the likelihood of developing sleep apnea, type 2 diabetes mellitus (T2DM), dyslipidemia, and hypertension. The rate of all-cause mortality in obese individuals is higher when compared to normal weight individuals.2 Its imperative that we address body weight with all patients in all health care settings – but particularly in primary care settings.

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Dec 6, 2013

We’ve all encountered patients who’ve had difficulty taking their medications as prescribed.  Many of our patients don’t achieve the recommended treatment goals or derive much benefit their medications.  There are many reasons why patients don’t take their medications in an ideal manner — including cost barriers, unpleasant side effects, treatment complexity, and forgetfulness.  

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Dec 20, 2012

Compelling indications in JNC7 that warrant β-blocker therapy include heart failure with reduced ejection fraction (HFrEF)2,3, acute myocardial infarction (AMI)4, high coronary disease risk, and diabetes.

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Jun 16, 2012

Blood pressure is known to follow a circadian rhythm in which the blood pressure falls by approximately 10% overnight. In many patients with hypertension (HTN) this drop in nocturnal blood pressure is blunted.  These patients are affectionately called “non-dippers.”  The non-dipping blood pressure pattern has been associated with a higher risk of cardiovascular events.  Several studies have evaluated the utility of changing blood pressure medication dosing times to bedtime.

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May 3, 2011

Are you treating to an evidence-based blood pressure goal in patients with diabetes?

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Apr 26, 2011

Nearly two-thirds of all Americans diagnosed with high blood pressure are treated with medications - but fewer than half are controlled to their goal.

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Feb 27, 2011

One in 3 adults in the United States have high blood pressure (HBP).1 That’s more than 74 million people!  From 1996 to 2006 the death rate due to HBP increased 19.5%.

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