The Curbsiders Internal Medicine Podcast
REBOOT #321 Hypertension FAQ: Common Outpatient Cases with Dr. Jordy Cohen
Jul 22, 2024
Expert in outpatient hypertension management, Dr. Jordy Cohen, discusses common scenarios including diagnosing hypertension, managing blood pressure in chronic kidney disease, and refractory hypertension. Topics covered include lifestyle modifications, medication initiation, affordability of generic pills, masked hypertension, ACE inhibitors vs. ARBs, and optimizing blood pressure in CKD patients.
01:23:11
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Quick takeaways
- Consider ACE inhibitors or ARBs for cardiovascular benefits despite creatinine concerns in CKD patients.
- Use 24-hour ambulatory blood pressure monitoring for accurate diagnosis of white coat hypertension.
Deep dives
Managing Blood Pressure in CKD Patients
Starting with a case study of a 62-year-old female with CKD stage 4 and high blood pressure, it highlights the importance of considering ACE inhibitors or ARBs for cardiovascular benefits despite concerns about creatinine levels and potassium, with a 30% increase in creatinine deemed acceptable. Loop diuretics like chlorothalidone are underutilized in CKD patients and have shown positive outcomes in reducing hypertension.
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