Editorial Board member Jay Shubrook and Advisory Board member Robert Chilton get together once more to discuss best practice tips for identifying and treating hypertension in patients with pre-existing diabetes (12:17).
Learning points include:
Strategies to avoid common pitfalls when performing blood pressure measurements.
The importance of the blood pressure measurements in determining the risk of cardiovascular events.
The benefits of dual-action and preload-targeted therapies in hypertensive patients.
Why potassium levels are an important factor to consider before initiating treatment.
In the wake of the revised blood pressure targets, recommended by the American Diabetes Association's 2017 Position Statement and 2018 Standards of Care, Editorial Board member Jay Shubrook and Advisory Board member Robert Chilton discuss clinical approaches to get hypertensive diabetes patients to target more consistently (12:29).
Learning points include:
The atherogenic risk posed by diabetes and why blood pressure measurements from the arm-alone may not be sufficient to evaluate the threat in all patients.
The benefits and drawbacks of the medication classes indicated for hypertension treatment, such as:
Diuretics
β-blockers
Calcium channel blockers
The impact and rationale for targeting blood pressures lower than those indicated in the ADA position statement.
Editorial Board member Jay Shubrook and lead author on the American Diabetes Association’s (ADA) 2017 Position Statement on diabetes and hypertension, Ian de Boer, summarize key updates to the recommendations for practitioners in the United States (11:32).
Editorial Board member Jay Shubrook and Advisory Board member Robert Chilton get together once more to discuss best practice tips for identifying and treating hypertension in patients with pre-existing diabetes (12:17).
Learning points include:
Strategies to avoid common pitfalls when performing blood pressure measurements.
The importance of the blood pressure measurements in determining the risk of cardiovascular events.
The benefits of dual-action and preload-targeted therapies in hypertensive patients.
Why potassium levels are an important factor to consider before initiating treatment.
Editorial Board member Jay Shubrook talks to treatment individualization specialist David Strain about the treatment challenges presented by older adults, and the implications for tailoring hypertension therapy in this diverse population (11:40).
Learning points include:
The ways in which older adults are physiologically distinct from other populations and considerations for appropriate care based on anticipated lifestyle.
Expectations for systolic and diastolic blood pressure changes in older adults as well as the impacts they have on cardiovascular health.
The importance of specific measures including: pulse pressure, arterial compliance.
Risk factors associated with low diastolic blood pressure (<75mmHg) and prospective antihypertensive treatment strategies that may mitigate such risks.
Editorial Board member Jay Shubrook follows up with treatment individualization specialist David Strain on the treatment challenges presented by older adults, and the implications for tailoring hypertension therapy in this diverse population (11:08).
Learning points include:
The rationale for emphasizing quality over quantity of life in certain subsets of the elderly patient population.
The importance of incorporating understanding of key comorbidities into treatment planning, including:
Left ventricular and/or diastolic dysfunction
Chronic kidney disease
Benign prostatic hyperplasia
Heart failure
Single/multi-agent therapies capable of targeting hypertension and its comorbidities.
The importance of early renal function testing in older adults initiated on treatments for hypertension and its comorbidities.
Understanding renal impairment risks in vulnerable adults treated with angiotensin-converting-enzyme (ACE) inhibitors in patients.
Understanding the relative risk of hyponatremia with generally well-tolerated treatments like as thiazide diuretics.
Best practice for avoiding adverse drug events in the acute setting.
The challenges associated with treating concomitant heart failure in older adults.
Intensive blood pressure management benefits patients whether or not they have diabetes and regardless of their baseline level of cardiovascular disease risk, shows a pooled analysis of the SPRINT and ACCORD-BP trials.
Finding from the PROCEED trial show that dietary salt restriction helps to reduce albuminuria in patients with type 2 diabetes taking losartan, the investigators report in The Lancet Diabetes & Endocrinology.
In: Managing Diabetic Eye Disease in Clinical Practice. Edited by Singh RP. Springer International Publishing, 2015. doi: 10.1007/978-3-319-08329-2_2
Ask the expert: Hypertension and diabetes
Editorial Board member Jay Shubrook and Advisory Board member Robert Chilton get together once more to discuss best practice tips for identifying and treating hypertension in patients with pre-existing diabetes (12:17).
Learning points include:
Strategies to avoid common pitfalls when performing blood pressure measurements.
The importance of the blood pressure measurements in determining the risk of cardiovascular events.
The benefits of dual-action and preload-targeted therapies in hypertensive patients.
Why potassium levels are an important factor to consider before initiating treatment.
Editorial Board member Jay Shubrook and lead author on the American Diabetes Association’s (ADA) 2017 Position Statement on diabetes and hypertension, Ian de Boer, summarize key updates to the recommendations for practitioners in the United States (11:32).
In the wake of the revised blood pressure targets, recommended by the American Diabetes Association's 2017 Position Statement and 2018 Standards of Care, Editorial Board member Jay Shubrook and Advisory Board member Robert Chilton discuss clinical approaches to get hypertensive diabetes patients to target more consistently (12:29).
Learning points include:
The atherogenic risk posed by diabetes and why blood pressure measurements from the arm-alone may not be sufficient to evaluate the threat in all patients.
The benefits and drawbacks of the medication classes indicated for hypertension treatment, such as:
Diuretics
β-blockers
Calcium channel blockers
The impact and rationale for targeting blood pressures lower than those indicated in the ADA position statement.
Editorial Board member Jay Shubrook talks to treatment individualization specialist David Strain about the treatment challenges presented by older adults, and the implications for tailoring hypertension therapy in this diverse population (11:40).
Learning points include:
The ways in which older adults are physiologically distinct from other populations and considerations for appropriate care based on anticipated lifestyle.
Expectations for systolic and diastolic blood pressure changes in older adults as well as the impacts they have on cardiovascular health.
The importance of specific measures including: pulse pressure, arterial compliance.
Risk factors associated with low diastolic blood pressure (<75mmHg) and prospective antihypertensive treatment strategies that may mitigate such risks.
Editorial Board member Jay Shubrook follows up with treatment individualization specialist David Strain on the treatment challenges presented by older adults, and the implications for tailoring hypertension therapy in this diverse population (11:08).
Learning points include:
The rationale for emphasizing quality over quantity of life in certain subsets of the elderly patient population.
The importance of incorporating understanding of key comorbidities into treatment planning, including:
Left ventricular and/or diastolic dysfunction
Chronic kidney disease
Benign prostatic hyperplasia
Heart failure
Single/multi-agent therapies capable of targeting hypertension and its comorbidities.
The importance of early renal function testing in older adults initiated on treatments for hypertension and its comorbidities.
Understanding renal impairment risks in vulnerable adults treated with angiotensin-converting-enzyme (ACE) inhibitors in patients.
Understanding the relative risk of hyponatremia with generally well-tolerated treatments like as thiazide diuretics.
Best practice for avoiding adverse drug events in the acute setting.
The challenges associated with treating concomitant heart failure in older adults.