Evidence-Based Hypertension (Evidence-Based Medicine)

✍ Scribed by Cynthia Mulrow

• Year: 2001
• Tongue: English
• Leaves: 249
• Edition: 1
• Category: Library

✦ Synopsis

This is a practice-oriented textbook for primary care clinicians on managing hypertension. The book summarizes all available research evidence that clinicians need to care for hypertensive patients. It also interprets the data to make it meaningful and useful and that advises readers about the quality and quantity of the evidence supporting the findings. Some of the main topics addressed in this book include taking accurate blood pressure measurements, determining the effectiveness of various blood pressure treatments, controlling difficult to control blood pressure, and treating hypertensive patients with other comorbid conditions.

✦ Table of Contents

Contents......Page 4
Contributors......Page 5
Glossary: How we defined the terms......Page 6
C H A P T E R 1 A guide to this book......Page 10
About the authors......Page 11
How content is organized......Page 12
How we rated the evidence......Page 13
References......Page 16
C H A P T E R 2 What is this person’s blood pressure?......Page 18
Patient Notes......Page 19
How should we measure blood pressure in the clinic?......Page 20
What interferes with accurate blood pressure measurement?......Page 23
What is the white-coat effect?......Page 26
How well does clinic measurement reflect “true” blood pressure?......Page 27
How many readings and visits are needed to diagnose hypertension?......Page 28
Should we recommend home self-measurement?......Page 29
blood pressure monitoring?......Page 31
Patient Notes......Page 34
References......Page 36
Acknowledgements......Page 41
C H A P T E R 3 How do cardiovascular risk factors affect whether we recommend therapy for hypertension?......Page 42
Patient Notes......Page 43
Patient Notes......Page 44
What blood pressure level is “hypertensive”?......Page 45
What risk factors determine poor cardiovascular prognosis?......Page 48
What tools help determine cardiovascular prognosis in individual patients, and how well do they work?......Page 63
Patient Notes: What is Mr Reaven’s relative risk?......Page 65
How do my patient and I decide whether treatment is worth considering?......Page 68
Patient Notes......Page 71
References......Page 72
Acknowledgements......Page 81
Appendix 1: Assessing coronary heart disease risk for women......Page 82
Appendix 2: Assessing coronary heart disease risk for men......Page 86
C H A P T E R 4 What are the elements of good treatment for hypertension?......Page 90
Patient Notes......Page 92
What are the therapeutic options for managing patients with high blood pressure?......Page 93
What are the benefits and harms of antihypertensive drug therapy for people with hypertension?......Page 95
What are the benefits and harms of treating dyslipidemia in people with hypertension?......Page 100
What are the benefits and harms of smoking cessation in people with hypertension?......Page 103
What are the benefits and harms of routine physical activity in people with hypertension?......Page 104
What are the benefits and harms of particular dietary interventions in people with hypertension?......Page 106
What are the benefits and harms of weight loss for hypertensive overweight patients?......Page 108
What are the benefits and harms of antiplatelet treatment in people with hypertension?......Page 109
What are the benefits and harms of modest alcohol consumption in people with hypertension?......Page 111
What are the benefits and harms of anticoagulant treatment in people with hypertension?......Page 112
What are the benefits and harms of various antioxidants and vitamins for people with hypertension?......Page 113
What are the benefits and harms of garlic, potassium, calcium, and magnesium supplementation in people with hypertension?......Page 115
Patient Notes......Page 117
References......Page 120
C H A P T E R 5 How do we best individualize treatment for patients based on their cardiovascular risk profile?......Page 126
Patient Notes......Page 127
What parameters should we consider when we help patients with multiple cardiovascular risk factors prioritize their treatments?......Page 128
Which therapies will most benefit patients with hypertension and other cardiovascular risk factors......Page 129
Which therapies will most benefit patients with hypertension, other cardiovascular risk factors, and known cardiovascular......Page 130
How do we help prioritize and sequence various treatments for hypertensive patients with multiple cardiovascular risk factors?......Page 131
Patient Notes......Page 134
Patient Notes......Page 135
Patient Notes......Page 136
Patient Notes......Page 137
C H A P T E R 6 How do we individualize antihypertensive therapy for patients with specific comorbid conditions?......Page 140
Patient Notes......Page 142
Which comorbid conditions have good indications to prescribe specific antihypertensive therapies?......Page 143
Which comorbid conditions do not have good indications to prescribe specific antihypertensive therapies?......Page 150
Which comorbid conditions have good indications to avoid specific antihypertensive therapies?......Page 152
Which comorbid conditions do not have good indications to avoid specific antihypertensive therapies?......Page 156
Which comorbid conditions have significant clinical trade-offs in prescribing or avoiding specific antihypertensive therapies?......Page 158
Which comorbid conditions have insufficient evidence to either prescribe or avoid specific antihypertensive therapies?......Page 160
Patient Notes......Page 161
References......Page 165
Acknowledgements......Page 168
C H A P T E R 7 How do we best monitor and facilitate chronic care for patients with hypertension?......Page 170
Patient Notes......Page 171
Patient Notes......Page 172
What are the best monitoring practices for following patients with hypertension?......Page 173
How can we predict, assess, and enhance adherence to prescribed therapeutic regimens?......Page 180
How can we best educate our patients about hypertension and its management?......Page 184
When is the ideal timing for patient revisits?......Page 185
Where should we follow-up patients with hypertension?......Page 187
Who should be involved in follow-up care of patients with hypertension?......Page 189
How should we manage and monitor patients with hypertensive urgencies and emergencies?......Page 190
Patient Notes......Page 194
References......Page 197
C H A P T E R 8 What do we do if our patient’s blood pressure is “difficult-to-control”?......Page 202
Patient Notes......Page 203
What can cause blood pressure to be “difficult-to-control,” and how frequent are these causes?......Page 204
How can we evaluate individual patients with “difficult-to-control” blood pressure to determine the cause(s) and adjust......Page 213
Patient Notes......Page 215
References......Page 217
C H A P T E R 9 What if my hypertensive patient becomes pregnant?......Page 220
Patient Notes......Page 222
How do we diagnose hypertension during pregnancy?......Page 223
What are the maternal and fetal risks for pregnant women with chronic hypertension?......Page 224
What are the therapeutic options for women with chronic hypertension who are considering pregnancy?......Page 226
What are the potential benefits of antihypertensive drug therapy for pregnant women with chronic hypertension?......Page 227
What are the harms of antihypertensive treatment during pregnancy?......Page 228
How do we weigh the potential benefits and harms of antihypertensive drug treatment during pregnancy?......Page 231
What are the potential benefits of aspirin for hypertensive pregnant women?......Page 232
Are there particular monitoring strategies during pregnancy that are warranted or proven beneficial for mothers or fetuses?......Page 234
Patient Notes......Page 235
References......Page 237
Index......Page 242