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of Hypertension
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IS MY PATIENT HYPERTENSIVE?
Definition of
hypertension
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Office BP ≥140/90 mmHg (newly diagnosed)
Hypertension confirmed
Recheck BP in a few
weeks or months
Or
No 160-179/100-109 mmHg
Do HBPM
Recheck BP in a few
days or weeks
2013 ESH/ESC
compelling indications]
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COMPELLING INDICATIONS
IN HYPERTENSION
Heart failure
Post-myocardial infarction
Diabetes
Kidney Albuminuria
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First objective is to reduce BP to 130-139/80-89 mm Hg
3 months after drug treatment initiation
If tolerated
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LIFESTYLE CHANGES
Salt restriction to 5–6 g per day
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Initiation of drug treatment
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Most hypertensive patients should initiate treatment
with a single pill combination comprising two
antihypertensive drugs
EXCEPT
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Preferred drugs for
uncomplicated hypertension, DM,
Stroke/TIA, PAD, or with HMOD,
DM = diabetes mellitus
TIA = transient ischemic attack
PAD = peripheral artery disease
HMOD = hypertension mediated organ damage
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Williams B, et al. Eur Heart J 2018. doi:10.1093/eurheartj/ehy339
PREFERRED DRUGS
kidney disease
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Hypertension and CKD
artery disease
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Hypertension and CAD
* EF ≤40%
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Hypertension and HFrEF
fibrillation
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Hypertension and atrial
fibrillation
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WHEN TO REFER
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