Hypertension Update 2018

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This issue will bring you up to date on the recent guidelines for the management of hypertension in adults.

Key Takeaways:
• Two guidelines, two definitions of hypertension: The 2017 ACC/AHA guideline defines stage 1 hypertension as a BP of 130/80 mmHg or above. In contrast, the hypertension guideline from the 8th Joint National Committee (JNC 8) defines hypertension as BP of 140/90 mmHg or above – an ongoing controversy.
• Think preventive: ACC/AHA recommends lifestyle changes for patients with “elevated” BP and those with stage 1 hypertension who have a 10-year cardiovascular risk less than 10%.
• First Line Treatments: Both JNC 8 and ACC/AHA recommend thiazide-type diuretics (TTDs), angiotensin converting enzyme inhibitors (ACEIs), angiotensin receptor blockers (ARBs), and calcium channel blockers (CCBs) as first line drug options.

Hypertension is a leading cause of cardiovascular disease, stroke, heart failure, and kidney disease. According to a recent update from the CDC National Center for Health Statistics, nearly 30% of adults in the US have hypertension. The rate of hypertension is similar among women (28%) and men (30%). It is more common among US non-hispanic black adults than any other ethnicity. Within age groups, the incidence ranges from 7.5% among adults 18-39 years old to 63% in those age 60 and older. Of concern is that hypertension control has not been improving. In 2015-2016, only 48% of adults with hypertension had achieved control which, at the time, was considered blood pressure less than 140/90 mmHg.

Recently, the American College of Cardiology (ACC) and the American Heart Association (AHA) released an updated guideline for the prevention, detection, evaluation and management of hypertension.2 The 2017 ACC/AHA guideline was developed and approved in collaboration with 9 other professional groups, including the American Pharmacists Association (APhA). A multidisciplinary, team-based approach to hypertension management is strongly recommended (including the patient, primary provider, and other professionals such as cardiologists, nurses, physician assistants, pharmacists, and dietitians)…

Full Issue Overview

About The Author:
Kimberly M. Crosby, PharmD, BCPS, CDE, BC-ADM,
BCGP is an Associate Professor in the Family Medicine
Department, College of Medicine, at the University of
Oklahoma (OU) School of Community Medicine. She
practices as a clinical pharmacist for the Tulsa
Family Medicine Clinic and the OU Bedlam Clinics.

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