so overdiagnosing hypertension seems generally harmless, yet underdiagnosing it might not be.
so overdiagnosing hypertension seems generally harmless, yet underdiagnosing it might not be. Furthermore, although ABPM and HBPM readings are better at predicting cardiovascular events than clinic readings, all of the studies demonstrating improved outcome from antihypertensive therapy have been based on a diagnosis made in a clinic setting.Tags: Top Creative Writing Masters Programs UkEssays On Isaac NewtonAssigned PortsEssay On Medieval WeaponsFirst Day Of School EssayLife In Prison Research PaperWhy Are You In College EssayUnit 8 Business Planning Coursework
In young people or those with resistant hypertension, renal ultrasound with Doppler of renal arteries can identify renal artery stenosis, although renal arterial angioplasty does not reliably lead to better BP control or preservation of renal function.
NICE guidelines have focused on ambulatory BP monitoring (ABPM).
Antihypertensive medication The treatment target in most patients is 140/90mm Hg, although this is lower (135/85mm Hg) in patients with diabetes mellitus and higher in those ≥80years (150/90mm Hg).
Many patients will require more than one agent, and it is important to discuss this when starting treatment.
Correspondence and requests for reprints to Patricia M.
Kearney, MBBCh BAO, MPH, Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, 1430 Tulane Avenue SL18, New Orleans, LA 70112, USA.
It is incongruous that they should be fourth line for hypertension in patients with quiescent coronary artery disease, but then receive an upgrade to first line once coronary artery disease becomes overt, despite the fact that BP lowering is the most powerful way to control both primary and secondary risk.
There are suggestions that they might be less protective against stroke and might increase the rate of diabetes.
Physical examination is nevertheless important since evidence of end-organ damage, such as a displaced apex beat due to left ventricular hypertrophy (LVH), or ocular changes, such as silver wiring and arteriovenous nipping, identifies patients at higher risk in whom there should be a lower threshold for treatment.
It is also useful to exclude radiofemoral delay (aortic coarctation), central obesity and abdominal striae (Cushing's syndrome) or skin thickening and bone changes (acromegaly).