#77 Hypertension Guidelines Showdown

#77 Hypertension Guidelines Showdown

Ease the tension around blood pressure goals in older adults and get inside the hypertension guidelines released by the ACP and ACC/AHA in 2017 with the sagacity of Dr. Mary Ann Forciea, MD, MACP, Professor of Medicine at University of Pennsylvania. We cover: how to properly measure blood pressure, how to diagnose hypertension, blood pressure targets, why BP goals differ by society, how to guidelines are written and how to interpret them with a critical eye, plus a hot take on the 2017 ACC/AHA guidelines. Dr. Shreya Trivedi joins as cohost. Special thanks to Hannah Abrams for her wonderful infographics and to Dr Trivedi for compiling our show notes.

Time Stamps

  • 00:00 The setup
  • 02:15 Disclaimer
  • 03:32 Picks of the Week
  • 08:13 Getting to know Dr Forciea
  • 13:35 Broad overview and a clinical case of geriatric hypertension
  • 14:45 Brief history on BP targets
  • 18:05 How do you measure a blood pressure? What type of monitors are available?
  • 22:13 How to standardize BP in the office?
  • 23:55 Ambulatory BP monitoring
  • 24:55 Home blood pressure monitoring
  • 26:11 Standing blood pressure readings and orthostatic hypotension
  • 27:53 How guidelines are written
  • 30:51 Evaluating evidence quality and strength of recommendation
  • 32:35 Timeline and process for guideline generation
  • 34:27 How to read guidelines with a “critical eye”
  • 36:15 Return to our case of uncontrolled hypertension
  • 38:25 Blood pressure targets from ACP guidelines and BP management in frail older adults
  • 40:33 Counsel patients on BP targets
  • 42:25 Low diastolic blood pressure
  • 45:35 SPRINT and the ACP BP guidelines
  • 48:58 Take home points from Dr Forciea
  • 50:07 HTN targets and pay for performance in clinical practice
  • 51:45 Curbsiders recap the ACP guidelines
  • 53:45 Matt and Paul recap the AHA guidelines
  • 54:47 AHA definitions of hypertension
  • 56:15 Diagnosing hypertension and how to measure a blood pressure
  • 60:35 Choosing a blood pressure monitor and HBPM
  • 62:29 Blood pressure goals in ACC guidelines
  • 66:08 Non-pharmacologic measures
  • 69:15 Will we follow these new strict targets?
  • 72:45 Outro

Tags:hypertension, blood, pressure, monitor, cuff, heart, aha, acc, act, stroke, cardiac, cardiovascular, event, guidelines, assistant, care, doctor, education, family, foam, foamed, health, hospitalist, hospital, internal, internist, meded, medical, medicine, nurse, practitioner, professional, primary, physician, resid

Episoder(500)

#488 DIGEST: Cytisinicline for smoking cessation, partner treatment for BV, combination therapy with statins and ezetimibe, and exercise and survival in colon cancer

#488 DIGEST: Cytisinicline for smoking cessation, partner treatment for BV, combination therapy with statins and ezetimibe, and exercise and survival in colon cancer

Join us as we review recent practice-changing articles on the effect of combination statin and ezetimibe in reducing myalgias, male partner treatment for BV, semaglutide for MASH/liver fibrosis, exercise and cancer risk, and cytisinicline for smoking cessation. Fill your brain hole with some delicious apps and entrees from our spring Digests! Featuring Paul Williams (@PaulNWilliamz), Nora Taranto (@norataranto), special guest epidemiologist Alexander Chaitoff (@alexchaitoff) and Matt Watto (@doctorwatto). Claim CME for this episode at curbsiders.vcuhealth.org! Patreon | Episodes | Subscribe | Spotify | YouTube | Newsletter | Contact | Swag! | CME Credits Written and Hosted by: Nora Taranto MD; Alexander Chaitoff MD, MPH; Paul Williams, MD, FACP, Matthew Watto MD, FACP, Alex Chaitoff MD MPH  Cover Art: Nora Taranto MD Reviewer: Leah Witt MD  Technical Production: Pod Paste Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP Show Segments Intro, disclaimer Self-collected HPV tests for cervical cancer screening  Semaglutide for MASH/Liver Fibrosis Male Partner Treatment for BV  Statins plus ezetimibe versus high-dose statins alone for statin-associated muscle symptoms  Exercise and Colon Cancer Risk  Cytisinicline for Smoking Cessation  Outro Disclosures Dr. Wiliams  reports financial relationship with Merck for grant or research support. Dr Chaitoff  reports financial relationship with  Alosa Health for Consulting. Other Curbsiders members report no relevant financial disclosures.  Sponsor: FIGS Curbsiders listeners can get 15% off. Just go to wearFIGS.com and use code FIGSRX Sponsor: Quince Go to Quince.com/curb for free shipping on your order and 365 day returns.  Sponsor: Continuing Education Company Curbsiders listeners get 45% off select online courses with promo code Curb45, through July 30. You can also use Curb30 for 30% off all webcasts and on demand replay courses. Check it all out at CMEmeeting.org/curbsiders.

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#487 Chronic Pain & Opioid Use Disorder with Dr. Jessie Merlin

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#486 Infertility in Clinical Practice: A Primary Care Approach  With Dr Brindha Bavan

#486 Infertility in Clinical Practice: A Primary Care Approach With Dr Brindha Bavan

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9 Jun 1h 14min

#485: Things We Do For No Reason™Live from SHM #Converge2025

#485: Things We Do For No Reason™Live from SHM #Converge2025

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2 Jun 1h 9min

#484 Hotcakes: Vitamin D3, Omega-3 Fatty Acids, and Physical Performance, Gabapentin and Falls, Gepotidacin for UTI, and Intermittent Fasting for Weight Loss

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#483: Diabetic Dilemmas in Older Adults, Pregnancy and Corticosteroid Use with Jeff Colburn, MD

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19 Mai 1h 19min

UNLOCKED #43 Exclusive! HFrEF (TFTC audio)

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14 Mai 30min

REBOOT #458 Heart Failure with Reduced Ejection Fraction - Kittleson Rules Outpatient Heart Failure Volume 1

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12 Mai 1h 3min

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