Pharmacotherapy Hypertension

Pharmacotherapy Hypertension

Multiple Choice

Cardiac Output is

• Stroke Volume x Blood Pressure

• Stroke Volume x Heart Rate

• Heart Rate x Blood Pressure

• Heart Rate x Afterload

Multiple Choice

Blood Pressure is

• Cardiac Output x Peripheral Resistance

• Heart Rate x Peripheral Resisitance

• Cardiac Output x Heart Rate

• Stroke Volume x Cardiac Output

Multiple Choice

what percent of patients have their Blood Pressure under control?

• 50%

• 57%

• 47%

• 52%

Multiple Choice

What percentage of Americans have Hypertention?

• 57%

• 47%

• 50%

• 40%

Fill in the Blank

What is the most common condition in primary care?

•HTN is the most common condition in primary care

–1 in 3 American adults have prehypertension

–46% of American adults have HTN

•Prevalence in patients 20 – 44 years old: 30% men and 19% women

•Prevalence in patients 65 – 74 years old: 77% men and 75% women

•Only about half (52%) of patients with HTN have it under control

•69% of people who have a first MI, 77% of people with a first CVA, and 74% of people with HF have HTN

Major risk factor for MI, CVA, ARF, and death

Multiple Choice

Hypertension is a major risk factor for

• Diabetes

• Cardiovascular Disease

• Obesity

• Depression

Multiple Choice

The risk of CVD begins at

• 120/80

• 130/80

• 115/75

• 140/90

Fill in the Blank

With each increment increase of 20 mmHg SBP or 10 mmHg DBP was associated with a _______ in the risk of death from stroke, heart disease or other vascular disease

Multiple Choice

In persons > 50 years, ____ is a much more important CVD risk factor than ____

• SBP, DBP

• DBP, SBP

Multiple Choice

What ethnicity develops HTN more often, and at an earlier age than other ethnicities

• Hispanics

• Asians

• Blacks

• Native Americans

Multiple Select

CVD major risk factors include

• Obesity

• Tobacco Use

• Dyslipiemia

• DM

• microalbuminuria or eGFR < 60 mL/min

Multiple Choice

What ages for women and men become a major risk factor for CVD?

• 55;65

• 50;60

• 65;55

• 60;50

Multiple Select

What are modifiable risk factors for CVD?

• Diabetes mellitus

• Overweight/Obesity

• Socioeconomic status

• Diet

• Obstructive sleep apnea

Multiple Select

What are non-modifiable risk factors for CVD?

• Age

• Overweight/Obesity

• Socioeconomic status

• Diet

• Obstructive sleep apnea

Multiple Choice

T/F: With increased patient age vasculature hardening is more common

• True

• False

CVD major risk factors

• HTN, cigarette smoking, obesity (BMI ≥ 30 kg/m2), physical inactivity, dyslipidemia, DM, microalbuminuria or eGFR < 60 mL/min, age (> 55 men, > 65 women), family history of premature CVD (men < 55, women < 65)

CVD major risk factors

HTN, cigarette smoking, obesity (BMI ≥ 30 kg/m2), physical inactivity, dyslipidemia, DM, microalbuminuria or eGFR < 60 mL/min, age (> 55 men, > 65 women), family history of premature CVD (men < 55, women < 65)

Multiple Select

What complications can be associated with HTN?

• Heart

• Brain

• PAD

• CKD

• Retinopathy

Multiple Select

When counseling a patient on HTN it can be good to mention that reducing blood pressure can also reduce which of the following

• Stroke incidence by 35-40%

• Myocardial Infarction (heart attack) by 45-50%

• Heat failure by 50%

• Obesity

Complications of HTN

• Heart

  –Left ventricular hypertrophy

  –Heart failure

  –Angina or myocardial infarction (MI)

  –Prior coronary revascularization

• Brain

  –CVA or TIA

• Chronic Kidney Disease (CKD)

• Peripheral Arterial Disease (PAD)

• Retinopathy

Multiple Choice

A patient with a blood pressure reading of 118/85 is classified as

• Normal

• Elevated BP

• Stage 1 HTN

• Stage 2 HTN

Multiple Choice

When evalauating BP which number dictates the BP category?

• Systolic

• Diastolic

• Lower

• Higher

Multiple Choice

A patients BP is 139/86 what is their BP classification?

• Normal

• Elevated

• Stage 1 HTN

• Stage 2 HTN

Multiple Choice

What is the Mean Arterial Pressure (MAP) of a patient with a BP measuring 118/78?

• 61 mmHg

• 93 mmHg

• 91 mmHg

• 65 mmHg

Multiple Choice

What is Mean Arterial Pressure an indicator of?

• Stroke Volume

• Renal Flow

• Vital Organ Perfusion

• Heart Attack

MAP is an indicator of organ perfusion and will be important when monitoring critical care patients

Multiple Choice

T/F: Should a patient be told their blood pressure after the reading is taken?

• True

• False

Multiple Choice

When taking a BP reading what rate should the cuff be deflated when finding the DBP?

• 1 mmHg/sec

• 2 mmHg/sec

• 3 mmHg/sec

• 4 mmHg/sec

Multiple Choice

If a patient with previosly normal BP presents to the clinic and 2 BP readings are taken both are high. Is it appropriate for them to be diagnosed with HTN at this visit?

• Yes

• No

Home and Ambulatory BP Monitoring

• Out-of-office BP measurements are recommended to confirm HTN dx and titration of BP-lowering medication

  –Should be used with telehealth counseling or clinical interventions

Fill in the Blank

____ HTN is higher office BPs than out-of-office BPs

Fill in the Blank

____ HTN is controlled office BPs but uncontrolled out-of-office settings

Multiple Choice

When is White Coat HTN clinically significant?

• SBP/DBPs are > 10/10 mmHg higher than HBPM or ABPM

• SBP/DBPs are > 20/20 mmHg higher than HBPM or ABPM

• SBP/DBPs are > 20/10 mmHg higher than HBPM or ABPM

• SBP/DBPs are > 15/10 mmHg higher than HBPM or ABPM

Multiple Choice

A patient recieving HTN treatment presents with unrecognized White Coat HTN could be misdiagnosed with

• Controlled HTN

• Stage 2 HTN

• Masked HTN

• Resistant HTN

Fill in the Blank

Masked HTN is associated with ____ prevalence of target organ damage and risk of CVD, stroke, and mortality compared with normotensive individuals and those with white coat hypertension

White Coat, Masked, & Sustained HTN

• White Coat HTN: higher office BPs than out-of-office BPs

  -Clinically significant when office SBP/DBPs are > 20/10 mmHg higher than HBPM or ABPM

  -Implicated in “pseudo-resistant HTN”

  -Results in underestimation of office BP control rates

  -Prevalence: higher in w/increasing age, females, nonsmokers and routine office BP measurement by clinician observers vs unattended BP measurements

• Masked HTN: controlled office BPs but uncontrolled out-of-office settings

  -Associated with increased prevalence of target organ damage and risk of CVD, stroke, and mortality compared with normotensive individuals and those with white coat hypertension 

Multiple Choice

A patient presents with an office BP of 145/82, they say they have been following the DASH diet and getting ~90 min exercise every week. The HBP log they brought in shows and average BP of 122/80. What type of BP does this patient have and when should they be followed up with?

• Masked HTN; 12 months

• White Coat HTN; 12 months

• Elevated BP; 1 month

• Stage 1 HTN; 1 month

Multiple Choice

A patient presents with an office BP of 118/79, they say they have been following the DASH diet and getting ~90 min exercise every week. The HBP log they brought in shows and average BP of 133/80. What type of BP does this patient have and when should they be followed up with?

• Masked HTN; 1 months

• White Coat HTN; 12 months

• Elevated BP; 1 month

• Stage 1 HTN; 1 month

Multiple Select

What factors would require an intisification of HTN therapy in a patient with detected masked HTN and currently on HTN therapy?

• Office BP is at goal

• HBPM and ABPM are above goal

• Patient shows no increased CVD risk or target organ damage

• Office BP is > 5-10 mmHg while on HTN therapy

Multiple Select

95% of patients have primary HTN, what are identified casues of primary HTN?

• Genetic

• Environmental

• Unknown

• Drugs

Multiple Select

Examples of environmentalcauses of primary HTN are

• Sodium intake

• Obesity

• Alcohol abuse

• Sedentary lifestyle

Primary or “Essential” HTN

• –95% of patients have primary HTN

• Cause unknown in most cases

  - Genetic

  High RAAS activity, SNS activity

  - Environmental

  Excess sodium intake, obesity sedentary lifestyle

Multiple Select

When screening for secondary HTN what would need to be or not be seen to refer a pateint to a clinician with expertise in this specialty?

• Disproportioante TOD for degree of HTN

• Positive screen for secondary HTN

• Unprovoked or excessive hyperkalemia

• Onset of HTN in pts < 30 y

• Drug resistant/induced HTN

Multiple Select

TOD indicates target organ damage. What are examples of damage?

• Cerebrovascular disease

• Left ventricular hypertrophy

• Rightventricular dysfunction

• Heart failure

• Albuminuria

TOD indicates target organ damage 

cerebrovascular disease, hypertensive retinopathy, left ventricular hypertrophy, left ventricular dysfunction, heart failure, coronary artery disease, chronic kidney disease, albuminuria, peripheral artery disease

Multiple Select

Examples of medications & other substances that may cause elevated BP

• Alcohol

• Antidepressants

• Decongestants

• Immunosuppresants

• •Systemic corticosteroids

Medications & Other Substances that May Cause Elevated BP

• •Alcohol

  •Amphetamines

  •Antidepressants

  •Atypical antipsychotics

  •Caffeine

  •Decongestants

  •Herbal supplements

• •Immunosuppresants

  •Oral contraceptives

  •NSAIDs

  •Recreational drug use

  •Systemic corticosteroids

  •Angiogenesis inhibitors 

Multiple Select

Three objectives in the evaluation of patients with documented HTN include

• To assess lifestyle and identify other CV risk factors

• To titrate HTN medications according to current lab values

• To reveal identifiable causes of high BP

• To assess the presence or absence of target organ damage and CVD

•Evaluation of patients with documented HTN has 3 objectives

• To assess lifestyle and identify other CV risk factors or concomitant disorders that may affect prognosis and guide treatment

• To reveal identifiable causes of high BP

• To assess the presence or absence of target organ damage and CVD

  •Target organ damage: microvascular and macrovascular injuries  

Multiple Select

A thorough medical evaluation includes

• Medical history

• Physical examination

• Routine laboratory tests

• Optional diagnostic procedures

Multiple Select

Routine laboratory tests in the medical evaluation for a patient with documented HTN include

• BMP

• FBG

• CBC w/differentials

• Urinalysis

• eGFR

Patient Evaluation

• A thorough medical evaluation includes

  –Medical history

  –Physical examination

  –Routine laboratory tests

  •BMP, FBG, CBC w/differentials, FLP, eGFR, TSH, Urinalysis, Serum Na, K, Ca2+

• Optional diagnostic procedures

  •Echocardiogram, Uric acid, UA:creatinine ratio

Multiple Select

BP lowering medications should be used in the primary prevention of CVD in adults with ____ history of CVD with an estimated 10-year ASCVD risk ____ 10% and an SBP ≥140 mmHg or DBP ≥90 mmHg

• no

• recurrent

• <

• >

Multiple Select

Secondary Prevention of ____ CVD events in patients with clinical CVD and an average SBP ≥___ mmHg or an average DBP ≥ 80 mmHg

• no

• recurrent

• 130

• 140

BP Treatment Threshold & the Use of CVD Risk Estimation to Guide Treatment of HTN

• BP-lowering medications should be used in:

  –Primary Prevention of CVD in adults with no history of CVD with an estimated 10-year ASCVD risk <10% and an SBP ≥140 mmHg or DBP ≥90 mmHg

• Secondary Prevention of recurrent CVD events in patients with clinical CVD and an average SBP ≥130 mmHg or an average DBP ≥ 80 mmHg

Multiple Select

What patient information is needed to fill in the ASCVD Risk calulator?

• Age

• Sex (at birth)

• Race

• BP

• On HTN treatment

Multiple Select

Under what conditions should a patient have their BP checked yearly?

• Normal BP

• Healthy life style promoted

• Elevated BP

• Stage 1 HTN

• Stage 2 HTN

Multiple Select

When should a patient with elevated BP and is practicing nonpharmacologocal therapies be re-evaluated?

• 1-2 months

• 3-6 months

• 8-9 months

• 12 months

Multiple Choice

When should a patient with Stage 1 HTN and an ASCVD risk greater than 10% and begins recieving pharmacological and nonpharmacological treatment have their BP re-evaluated?

• 1 month

• 3 months

• 6 months

• 12 months

Multiple Choice

A patient with Stage 2 HTN who is on nonpharmacological and 2 pharmacological treatments for HTN and is meeting their BP goal should be reassed in how many months?

• 1-2 months

• 3-6 months

• 7-8 months

• 12 months

Multiple Select

Most clinical conditions have a BP threshold of 130(SBP) or 130/80 and a goal of 130/80. What conditions is threshold 140/90?

• Older persons

• No clinical CVD or ASCVD risk <10%

• Clinical CVD or >10% ASCVD risk

• Stable Ischemic heart disease

• Stroke

BP Thresholds & Goals of Pharmacological Therapy 

Multiple Select

What are the primary oral antihypertensive medication classes

• Thiazides

• ACEIs

• ARBs

• CCBs

• Beta Blockers

Multiple Select

Secondary agents used in the oral treatment of HTN include

• Loop and K+ sparing diuretics

• Aldosterone antagonists

• Beta blockers

• Alpha-1 blockers

• Direct vasodialators

Oral Antihypertensive Drugs

• Primary Agents

  •Thiazide/thiazide-like diuretics

  •ACEIs

  •ARBs

  •CCBs 

• Secondary Agents

  •Loop diuretics

  •K+ sparing diuretics

  •Aldosterone antagonists

  •Beta-blockers

  •Direct-Renin Inhibitors

  •Alpha-1 blockers

  •Central alpha-2 agonists

  •Direct vasodilators 

Multiple Select

Which of the below medications are available in liquid form?

• Amlodipine

• Hydrochlorothizide

• Enalapril

• Valsartan

• Lisinoprl

Multiple Choice

Which α2-adrenergic agonist is avaialbel as a patch?

• Guanfacine

• Tizanidine

• Clonidine

• Dexmedetomidine

Multiple Choice

Stage 1 HTN patients with a BP goal of 130/80 mmHg should initially recieve what type of therapy in addition to nonpharmacological therapy

• Monotherapy

• Combination therapy

• No therapy

Multiple Choice

What Stage of Hypertension will a patient initially recieve combination therapy along with nonpharmacological therapy?

• Normal

• Elevated

• Stage 1

• Stage 2

Choice of Medication

• First-line Agents

  –Thiazide-diuretics, ACEIs, ARBs, CCBs

• Initial Monotherapy

  –Stage I HTN: start with a single antihypertensive drug is reasonable

  –Dosage titration and sequential addition of other agents to achieve the BP target

  –BP goal <130/80 mm Hg 

• Initial Combination Therapy

  –Stage 2 HTN (w/avg BP > 20/10 mmHg above BP target): start with 2 first-line agents of different classes, either as separate agents or in a fixed-dose combination

Follow-Up & Monitoring

• Adults initiating a new or adjusted drug regimen for hypertension should have a follow-up evaluation of adherence and response to treatment every month until control is achieved

• Follow-up and monitoring after initiation of drug therapy for hypertension control should include systematic strategies to help improve BP, including use of HBPM, team-based care, and telehealth strategies. 

Multiple Select

The preferred antihypertensive agents in patients with systolic heart failure include

• ACEIs

• ARBs

• Aldosterone antagonist

• Diuretics

• Beta blockers

Multiple Select

The preferred antihypertensive agents in patients post MI include

• ACEIs

• ARBs

• Aldosterone antagonist

• Diuretics

• Beta blockers

Multiple Select

The preferred antihypertensive agents in patients with CKD nclude

• ACEIs

• ARBs

• CCBs

• Diuretics

• Beta blockers

Multiple Select

The preferred antihypertensive agents in patients with Diabetes include

• ACEIs

• ARBs

• CCBs

• Thiazides

• Beta blockers

Multiple Select

The preferred antihypertensive agents in patients with angina pectoris include

• ACEIs

• ARBs

• CCBs

• Thiazides

• Beta blockers

Multiple Select

The preferred antihypertensive agents in patients that are pregnant include

• Lisinopril

• Losartan

• Nifedipine CC

• Methyldopa

• Labetalol

•Preferred Medication for Certain Populations

Multiple Select

Beta blockers have a favorable effect on what conditions other than HTN?

• Hyperthyroidism

• Migraine

• Osteoporosis

• Perioperative HTN

• BPH

Multiple Choice

Alpha blockers have a favorable effect on what conditions other than HTN?

• Hyperthyroidism

• Migraine

• Osteoporosis

• Perioperative HTN

• BPH

Multiple Choice

Thiazide diuretics have a favorable effect on what conditions other than HTN?

• Hyperthyroidism

• Migraine

• Osteoporosis

• Perioperative HTN

• BPH

Multiple Choice

Noncardioselective beta blockers have a favorable effect on what conditions other than HTN?

• Hyperthyroidism

• Migraine

• Osteoporosis

• Perioperative HTN

• Essential tremor

Multiple Select

What HTN meidcations are contraindicated in Angioedema

• ACEIs

• ARBs

• CCBs

• Aliskerin

• Beta blockers

Multiple Select

What HTN meidcations are contraindicated in Preganacy

• ACEIs

• ARBs

• CCBs

• Aliskerin

• Beta blockers

Multiple Select

What HTN meidcations are contraindicated in Hyperkalemia

• ACEIs

• ARBs

• CCBs

• Aliskerin

• Aldosterone antagonists

Multiple Select

What HTN meidcations are contraindicated in Bilateral renal stenosis

• ACEIs

• ARBs

• CCBs

• Aliskerin

• Aldosterone antagonists

Multiple Select

What HTN meidcations are contraindicated in Acute renal failure

• ACEIs

• ARBs

• Thiazide diuretics

• Aliskerin

• Aldosterone antagonists

Open Ended

Your preceptor asks you to speak with a patient about suppliments for HTN. What advice do you have for the patient about the use of suppliments?

Multiple Choice

When treating patients with stable ischemic heart disease whose BP goal of <130/80 is not met with GDMT and is experiencing angina pectoris should also recieve what type of medications?

• nonDHPCCB

• DHPCCB

• ARB

• Thiazide

Multiple Choice

Patients with HTN and CKD that cannot tolerate ACEIs should recieve an ARB. However, pateints post renal transplantation should recieve what type of medications?

• Beta blockers

• Alpha blocker

• CCB

• Thiazide

Multiple Select

Drugs of choice for adult patients with previously treated HTN + stroke/transient ischemic attack (TIA) are

• ACEIs

• ARBs

• CCBs

• Thiazides

• Combination

Multiple Select

Adults NOT previously treated for HTN + stroke/TIA and have an established BP ≥140/90 mm Hg should have thier medication administration selection based on what?

• HTN meds should be initiated immediatly

• HTN meds should be started a few days after the event

• Should be based on the treatments used for patients who have previously recieved HTN treatment

• Should be based on the patients comorbidities

Multiple Choice

Hypertension management in patients with PAD should be treated

• with Beta blockers

• with CCBs

• similarly to patients without PAD

• with aldosterone antagonists

Multiple Select

Hypertension management in patients with DM can be treated with

• ACEIs

• ARBs

• Thiazides

• CCBs

Multiple Choice

Hypertension management in patients with AFIB can be treated with

• ACEIs

• ARBs

• Thiazides

• CCBs

Multiple Choice

Which beta blocker should not be used in the treatment of HTN in patients with stable ischemic heart disease?

• Metoprolol

• Timolol

• Atenolol

• Carvedilol

• Propranolol

Multiple Choice

Older Persons ≥ 65 years of age SBP treatment goal <___ recommended for noninstitutionalized ambulatory community-dwelling adults

• 120

• 130

• 140

Special Patient Groups

• Race & Ethnicity

  –Black adults without HF or CKD: initial treatment should include thiazide diuretic or CCB

  –2 or more medications are recommended to achieve goal BP in most adults and especially black adults w/HTN

• Older Persons (≥ 65 years of age)

  –SBP treatment goal <130 recommended for noninstitutionalized ambulatory community-dwelling adults

  –Patients with high-burden of comorbidity & limited life expectancy, clinical judgement, patient preference, & a team-based approach assess risk/benefit regarding intensity of BP lowering & choice of drugs

Multiple Select

Women who are planning or become pregnant should be transitioned to what medications for HTN management

• Lisinopril

• Valsartan

• Nifedipine CC

• Labetalol

• Methyldopa

Treatment during pregnancy

• –Women who are planning or become pregnant should be transitioned to methyldopa, nifedipine, and/or labetalol during pregnancy; use the lowest effective dose possible

  –Do not treat with ACEIs, ARBs, or direct renin inhibitors

  –Use drugs that have been used the longest periods of time with safety

• •Gestational Hypertension (chronic): > 140/90 prior to pregnancy or before 20 weeks gestation. Persists > 12 weeks postpartum

  –Treat if SBP > 160 or DBP >105

  •BP target 120 – 160 SBP and 80 – 105 DBP

  –Drugs of choice: methyldopa, labetalol, nifedipine ER

• •Preeclampsia: > 140/90 with proteinuria

  –Must be treated and monitored for progression carefully

Multiple Select

How is a patient evaluated for resistant HTN ?

• Confirm treatment resistance

• Exclude pseudoresistance

• Assess for secondary HTN

• Assess for target organ damage

Multiple Choice

The management of resistant HTN entails how many steps?

• 4

• 5

• 6

• 7

Multiple Select

Step one in the management of resistant HTN includes

• Excluding other causes of HTN

• Ensure low sodium diet and appropriate lifestyle modifications

• Substitute optimally dosed thiazide-like diuretics

• Add MRA

• Optimize a three drug regimine

Multiple Choice

Step two in the management of resistant HTN includes

• Excluding other causes of HTN

• Ensure low sodium diet and appropriate lifestyle modifications

• Substitute optimally dosed thiazide-like diuretics

• Add MRA

• Optimize a three drug regimine

Multiple Choice

Step three in the management of resistant HTN includes

• Excluding other causes of HTN

• Ensure low sodium diet and appropriate lifestyle modifications

• Substitute optimally dosed thiazide-like diuretics

• Add MRA

• Optimize a three drug regimine

Multiple Choice

Step four in the management of resistant HTN includes

• Check heart rate and add a beta blocker

• Ensure low sodium diet and appropriate lifestyle modifications

• Substitute optimally dosed thiazide-like diuretics

• Add MRA

• Optimize a three drug regimine

Multiple Choice

Step five in the management of resistant HTN includes

• Check heart rate and add a beta blocker

• Ensure low sodium diet and appropriate lifestyle modifications

• Substitute optimally dosed thiazide-like diuretics

• Add hydralazine

• Optimize a three drug regimine

Multiple Choice

Step six in the management of resistant HTN includes

• Check heart rate and add a beta blocker

• Ensure low sodium diet and appropriate lifestyle modifications

• Substitute optimally dosed thiazide-like diuretics

• Add hydralazine

• Substiture minoxidil for hydralazine

Multiple Choice

T/F: A hypertensive crisis requires admission to the ICU

• True

• False

Multiple Select

In the management of a hypertensive crisis how much should BP be lowered in the 1st hour?

• Reduce SBP to <140 mmHg in pre-eclampsia and pheochromocytoma

• Reduce to <120 mmHg in aortic disection

• Reduce to <120 mmHg if pateint has not experienced aortic dissection, pre-eclampsia or pheochromocytoma

• Reduce by 25% mmHg if pateint has not experienced aortic dissection, pre-eclampsia or pheochromocytoma

Hypertensive Crises:

Emergencies & Urgencies

• Hypertensive emergency

  –Admission to an ICU is recommended for continuous monitoring of BP and target organ damage and for parenteral administration of an appropriate agent

  –

  –Compelling condition (i.e., aortic dissection, severe preeclampsia or eclampsia, or pheochromocytoma crisis), SBP should be reduced to < 140 mm Hg during the first hour and to < 120 mm Hg in aortic dissection

  –

  –Without a compelling condition, SBP should be reduced by no more than 25% within the first hour; then, if stable, to 160/100 mm Hg within the next 2 to 6 hours; and then cautiously to normal during the following 24 to 48 hours

Multiple Select

What are the strategies used to improve HTN treatment and control

• Medication Adherence

• Lifestyle Modification

• Provider Silo based care

• EHR & Patient Registries

• Telehealth strategies

Strategies to Improve HTN Treatment and Control

• •Medication Adherence

  –Dose antihypertensive meds once vs multiple times daily

  –Use combination pills rather than free individual components

• •Lifestyle Modification

  –Effective behavioral and motivational strategies to achieve a healthy lifestyle

• •Team-based Care

  –Recommended approach for treatment

• •EHR & Patient Registries

  –Useful to identify patients with undiagnosed/undertreated HTN

• •Telehealth strategies 

Multiple Select

A plan of care for HTN should include a clear, detailed, and current evidence-based plan of care that ensures

• The achievement of treatment & self-management goals

• Encourages effective management of comorbid conditions

• Prompts timely follow-up with the healthcare team

• Adheres to CVD GDMT

Open Ended

A patient was notified that the Valsartan they have been taking was recalled for causing cancer. They are now calling and asking what they should do. Your preceptor wants you to speak with the patient. What do you tell the pateint?