The Curbsiders Internal Medicine Podcast #343 Hypertension FAQ and Cardiorenal: A rapid review (TFTC)
Jun 29, 2022
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Confirm High Office BPs With Out‑of‑Office Readings
- Confirm office high BPs with standardized home or ambulatory measurements before diagnosing hypertension.
- Instruct patients on proper technique and average multiple readings (e.g., 2 morning + 2 evening over 3 days).
Masked Hypertension Is Common And Risky
- White‑coat and masked hypertension are opposite and both matter for risk assessment.
- Masked hypertension (normal clinic, high home) affects ~25% and requires active out‑of‑office screening.
Prefer ARBs And Pick Long‑Acting Agents
- Prefer ARBs over ACE inhibitors for initial renin‑angiotensin blockade because ARBs have similar benefits and fewer adverse effects.
- Choose agents with favorable pharmacology (eg, olmesartan) or use losartan twice daily if duration is inadequate.