The Curbsiders Internal Medicine Podcast REBOOT #321 Hypertension FAQ: Common Outpatient Cases with Dr. Jordy Cohen
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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.
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Confirming Hypertension Diagnosis
- Confirm hypertension diagnosis with at least two office visits, ideally three months apart, using standardized measurements.
- Use validated automated office blood pressure or high-quality manual readings, considering factors like clothing, cuff size, and patient positioning.
Dental Office Blood Pressures
- Dental office blood pressures are often unreliable due to patient anxiety and pain, so they shouldn't be the sole basis for diagnosis.
- While dental readings can raise a flag, they should be verified with standardized measurements in a clinical setting.
Out-of-Office Blood Pressure Checks
- Use out-of-office blood pressure checks (home or 24-hour ambulatory) to confirm hypertension diagnosis.
- Train patients on proper home blood pressure measurement using resources like the infographics at targetbp.org.