The Curbsiders Internal Medicine Podcast

#390 Resistant Hypertension

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Apr 17, 2023
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ADVICE

Use 130/80 As Default Target

  • Use 130/80 mmHg as the default diagnostic and treatment threshold for most adults.
  • Discuss individualized goals with patients before intensifying therapy.
INSIGHT

Two Dominant Mechanisms Of Hypertension

  • Essential hypertension is usually a mix of volume (RAS) and sympathetic mechanisms.
  • Fixed-dose combinations work well because they target multiple mechanisms at once.
ADVICE

Treat Anxiety To Help BP Control

  • Ask patients about anxiety and consider treating it as part of BP management.
  • Consider sertraline for labile, anxiety-linked hypertension when appropriate.
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