chobanian av et al. jnc 7 report. hypertension...
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Chobanian AV et al. JNC 7 Report. Hypertension 2003;42;1206-52
Chobanian AV et al. JNC 7 Report. Hypertension 2003;42;1206-52
Kaplan NM. J Hypertens 2005;23:1441-4
Schlaich M et al. Curr Hypertens Rep. 2010;12:296-302
Step 1: Confirm Treatment Resistance ● Office BP >140/90 or >130/80 mmHg in patients with CKD or DM and ● Patient prescribed 3 or more meds at optimal doses, including a diuretic or ● Office BP at goal but patient requires 4 or more medications
Step 1: Confirm Treatment Resistance
Step 2: Exclude Pseudo-Resistance
Sarafidis P and Bakris G. JACC 2008;52:1749-57
Step 1: Confirm Treatment Resistance
Step 3: Identify Factors that Contribute to Treatment Resistance
● Lifestyle factors ● Interfering substances ● Secondary causes of hypertension
Step 2: Exclude Pseudo-Resistance
Bramlage P et al. Am J Hypertens 2004;17:904-10
Chobanian AV et al. JNC 7 Report. Hypertension 2003;42;1206-52
Chobanian AV et al. JNC 7 Report. Hypertension 2003;42;1206-52
Singer et al. Hypertension. 1991;17:798-803
Conlin PR et al. Hypertension 2000;36:461-5
Bakris GL et al. Am Fam Physician 1989;40:199-204
Sarafidis P and Bakris G. JACC 2008;52:1749-57
Logan et al. J Hypertens. 2001;19:2271-2277
Grote et al. J Hypertens. 2000;18:679-685
Somers et al. J Clin Invest. 1995;96:1897-1904
Cushman et al. J Clin Hypertens. 2002;4:393-404
Singer et al. Hypertension. 2002;40:464-9
Step 1: Confirm Treatment Resistance
Step 2: Exclude Pseudo-Resistance
Step 3: Identify Factors that Contribute to Treatment Resistance
Step 4: Nonpharmacologic Treatment ● Reverse contributing lifestyle factors ● Discontinue or minimize interfering substances ● CPAP
Step 1: Confirm Treatment Resistance
Step 2: Exclude Pseudo-Resistance
Step 3: Identify Factors that Contribute to Treatment Resistance
Step 4: Nonpharmacologic Treatment
Step 5: Pharmacologic Treatment