The Curbsiders Internal Medicine Podcast #474 Resistant Hypertension the Next Frontier
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Mar 10, 2025 In this engaging discussion, Dr. Jordana Cohen, a nephrologist and hypertension specialist from the University of Pennsylvania, shares her insights on managing resistant hypertension. She dives into innovative treatments, including GLP-1 agonists and aldosterone synthase inhibitors, and discusses emerging therapies that show promise. The conversation also highlights the evolution of blood pressure measurement techniques and the significance of personalized treatment plans, offering practical advice and new hope for tackling this widespread condition.
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Accurate Blood Pressure Measurement
- Measure blood pressure correctly, as routine clinic readings can be inaccurate.
- Use home blood pressure monitors and train patients on proper usage.
Automated vs. Manual Cuffs
- Automated blood pressure cuffs with averaging capabilities overcome white coat effect more effectively than manual cuffs.
- Manual aneroid devices are prone to miscalibration and don't account for age-related hearing loss or auscultatory gaps.
Educating Patients on Home Monitoring
- Recheck blood pressure in the room and verbally explain proper technique to educate patients on home monitoring.
- Be explicit about feet placement, cuff position, and arm support.