michigan hypertension core curriculum - State of Michigan

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References: 1. U.S. Renal Data System, USRDS 2008 Annual Data Report: Atlas of End-Stage Renal Disease in the United States. In: National Institutes of Health N, Bethesda, MD, 2008, ed.; 2008. 2. Cooper-DeHoff RM, Aranda JM, Jr., Gaxiola E, et al. Blood pressure control and cardiovascular outcomes in high-risk Hispanic patients--findings from the International Verapamil SR/Trandolapril Study (INVEST). Am Heart J 2006;151:1072-9. 3. Pollak MR. Kidney disease and African ancestry. Nat Genet 2008;40:1145-6. 4. Lea J, Cheek D, Thornley-Brown D, et al. Metabolic syndrome, proteinuria, and the risk of progressive CKD in hypertensive African Americans. Am J Kidney Dis 2008;51:732-40. 5. Barri YM. Hypertension and kidney disease: a deadly connection. Curr Hypertens Rep 2008;10:39-45. 6. Banerjee D, Contreras G, Jaraba I, et al. Chronic kidney disease stages 3-5 and cardiovascular disease in the veterans affairs population. Int Urol Nephrol 2009. 7. McCullough PA, Li S, Jurkovitz CT, et al. Chronic kidney disease, prevalence of premature cardiovascular disease, and relationship to short-term mortality. Am Heart J 2008;156:277-83. 8. Foley RN, Parfrey PS, Sarnak MJ. Clinical epidemiology of cardiovascular disease in chronic renal disease. Am J Kidney Dis 1998;32:S112-9. 9. Brantsma AH, Bakker SJ, Hillege HL, de Zeeuw D, de Jong PE, Gansevoort RT. Cardiovascular and renal outcome in subjects with K/DOQI stage 1-3 chronic kidney disease: the importance of urinary albumin excretion. Nephrol Dial Transplant 2008;23:3851-8. 10. Parikh NI, Hwang SJ, Larson MG, Levy D, Fox CS. Chronic kidney disease as a predictor of cardiovascular disease (from the Framingham Heart Study). Am J Cardiol 2008;102:47-53. 11. Peralta CA, Hicks LS, Chertow GM, et al. Control of hypertension in adults with chronic kidney disease in the United States. Hypertension 2005;45:1119-24. 12. Wong ND, Lopez VA, L'Italien G, Chen R, Kline SE, Franklin SS. Inadequate control of hypertension in US adults with cardiovascular disease comorbidities in 2003-2004. Arch Intern Med 2007;167:2431-6. 13. Pogue V, Rahman M, Lipkowitz M, et al. Disparate estimates of hypertension control from ambulatory and clinic blood pressure measurements in hypertensive kidney disease. Hypertension 2009;53:20-7. 14. Ibrahim HN, Wang C, Ishani A, Collins AJ, Foley RN. Screening for chronic kidney disease complications in US adults: racial implications of a single GFR threshold. Clin J Am Soc Nephrol 2008;3:1792-9. 15. Kramer H, Palmas W, Kestenbaum B, et al. Chronic kidney disease prevalence estimates among racial/ethnic groups: the Multi-Ethnic Study of Atherosclerosis. Clin J Am Soc Nephrol 2008;3:1391-7. 16. Mehrotra R, Kermah D, Fried L, Adler S, Norris K. Racial differences in mortality among those with CKD. J Am Soc Nephrol 2008;19:1403-10. 17. Duru OK, Li S, Jurkovitz C, et al. Race and sex differences in hypertension control in CKD: results from the Kidney Early Evaluation Program (KEEP). Am J Kidney Dis 2008;51:192-8. 18. Yusuf S, Sleight P, Pogue J, Bosch J, Davies R, Dagenais G. Effects of an angiotensinconverting-enzyme inhibitor, ramipril, on cardiovascular events in high-risk patients. The Heart Outcomes Prevention Evaluation Study Investigators. N Engl J Med 2000;342:145-53. 19. Bakris GL, Williams M, Dworkin L, et al. Preserving renal function in adults with hypertension and diabetes: a consensus approach. National Kidney Foundation Hypertension and Diabetes Executive Committees Working Group. Am J Kidney Dis 2000;36:646-61. 20. Chobanian AV, Bakris GL, Black HR, et al. Seventh report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. Hypertension 2003;42:1206- 52. 48 Hypertension Core Curriculum
21. Onuigbo MA. RAAS blockade, renal failure, ESRD, and death among African Americans in the AASK Posttrial Cohort Study. Arch Intern Med 2008;168:2383-4. 22. Appel LJ, Wright JT, Jr., Greene T, et al. Long-term effects of renin-angiotensin system-blocking therapy and a low blood pressure goal on progression of hypertensive chronic kidney disease in African Americans. Arch Intern Med 2008;168:832-9. 23. Bakris GL, Gaxiola E, Messerli FH, et al. Clinical outcomes in the diabetes cohort of the INternational VErapamil SR-Trandolapril study. Hypertension 2004;44:637-42. 24. Maschio G, Alberti D, Locatelli F, et al. Angiotensin-converting enzyme inhibitors and kidney protection: the AIPRI trial. The ACE Inhibition in Progressive Renal Insufficiency (AIPRI) Study Group. J Cardiovasc Pharmacol 1999;33 Suppl 1:S16-20; discussion S41-3. 25. Lewis EJ, Hunsicker LG, Bain RP, Rohde RD. The effect of angiotensin-converting-enzyme inhibition on diabetic nephropathy. The Collaborative Study Group. N Engl J Med 1993;329:1456-62. 26. Julius S, Kjeldsen SE, Weber M, et al. Outcomes in hypertensive patients at high cardiovascular risk treated with regimens based on valsartan or amlodipine: the VALUE randomised trial. Lancet 2004;363:2022-31. 27. Mann J, Julius S. The Valsartan Antihypertensive Long-term Use Evaluation (VALUE) trial of cardiovascular events in hypertension. Rationale and design. Blood Press 1998;7:176-83. NKFM & MDCH 49
Page 1: MICHIGAN HYPERTENSION CORE CURRICUL
Page 4 and 5: April 2010 Dear Colleague: In 2005,
Page 6 and 7: Kevin L. Piggott, MD, MPH, FAAFP Pr
Page 8 and 9: Blood Pressure Measurement........
Page 10 and 11: 10 Hypertension Core Curriculum Blo
Page 12 and 13: of the wrist. Additionally, there i
Page 14 and 15: asis. National guidelines recommend
Page 16 and 17: Post-Test Questions: 1. High BP is
Page 18 and 19: 18 Hypertension Core Curriculum Ess
Page 20 and 21: Masked Hypertension is when the off
Page 22 and 23: TABLE 1. Prevalence of Awareness, T
Page 24 and 25: Blood Pressure, Circulatory Physiol
Page 26 and 27: side of the vascular tree. Arterial
Page 28 and 29: upon the other co-morbidities prese
Page 30 and 31: Table 3. Clinically Available Clues
Page 32 and 33: In the setting of chronic hypertens
Page 34 and 35: 34 Hypertension Core Curriculum Tab
Page 36 and 37: cause greater disruption of CBF aut
Page 38 and 39: References/Suggested Reading Agabit
Page 40 and 41: 40 Hypertension Core Curriculum Chr
Page 42 and 43: development of essential HTN can se
Page 44 and 45: Figures: Figure 1. Pie-chart with m
Page 46 and 47: Table 2 Table 3 Screening Test for
Page 50 and 51: 50 Hypertension Core Curriculum Spe
Page 52 and 53: side effects particularly well. A h
Page 54 and 55: 14. Gaede P, Vedel P, Larsen N, Jen
Page 56 and 57: Learning Objectives: 56 Hypertensio
Page 58 and 59: glycemic risk factdors such as hype
Page 60 and 61: . Weight loss c. Weight gain d. A a
Page 62 and 63: References: 1. Association AD. All
Page 64 and 65: 64 Hypertension Core Curriculum Spe
Page 66 and 67: foods and turn out of necessity to
Page 68 and 69: Figure 1: Table 1. Metabolic Syndro
Page 70 and 71: 9. Singh GK, Kogan MD, Van Dyck PC,
Page 72 and 73: Incidence and Prevalence The overal
Page 74 and 75: access to healthy foods than their
Page 76 and 77: As a part of the approach to managi
Page 78 and 79: B Hypertensive Adults (rate, percen
Page 80 and 81: References: 1. Lewington S, Clarke
Page 82 and 83: 82 Hypertension Core Curriculum
Page 84 and 85: appear to be related to access to c
Page 86 and 87: CDC MMWR Feb 24, 2006/55(07); 177-1
Page 88 and 89: Figure 1; Clinical presentation and
Page 90 and 91: 90 Hypertension Core Curriculum Phe
Page 92 and 93: ANY patient, who develops paroxysma
Page 94 and 95: Figure 1: 94 Hypertension Core Curr
Page 96 and 97: Objectives: 96 Hypertension Core Cu
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Definition Prevalence Clinical Feat
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intake. 4 Figure 1; Ion transport i
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loading with 200 mmoles (4.6 grams)
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Figure 3; Endocrine Society See tex
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INTRODUCTION 106 Hypertension Core
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Renal manifestations. Renal ischemi
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to assess renal dimensions and dupl
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stenosis severity. Patients with no
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ARAS, ischemic nephropathy, and imp
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the goals of minimizing injury to t
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hemodynamically impaired renal arte
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e classified as having “renovascu
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disease of the abdominal aorta and
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Table 1. Contemporary evaluation of
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2. Screening tests for RAS RDU, MRA
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Manifestations of vital organ injur
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Table 6. Clinical evaluation of ren
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Table 9. Assessment of worsening re
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Table 11. New terminology for renal
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References: 1. Murphy TP, Soares G,
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2001;12(6):1235-1241. 40. Subramani
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78. Tami LF, McElderry MW, al-Adli
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142 Hypertension Core Curriculum Pr
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monitored hypertension screening an
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Policy Development: Public health p
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Med Clin North Am. Jan 2004;88(1):2
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mind they will have no problem iden
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Role of Race in the Selection of An
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individuals of any race or ethnicit
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Older Patients Need Elevated Systol
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sister, mother and father. A family
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ecause pressure-related retinopathy
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pulses (lower in the left arm). 4 C
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Vital signs suggestive of OSAHS. 20
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may shed light on underlying medica
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References: patients. 8 However, th
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Objectives: 170 Hypertension Core C
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and evidence that anti-hypertensive
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When subjects are given instruction
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interestingly found only a 6.0/4.6
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pressure: a meta-analysis of random
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isolated systolic hypertension have
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Compelling Indications for Specific
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3.) Beta-blockers, ACE inhibitors,
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treatment levels - albeit though at
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Preparations and Dosage: Oral antih
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Preparations and Dosages: The Oral
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patients with tachy-brady syndrome
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significant proteinuria. Pharmacolo
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the effect found by the ACE inhibit
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and nominally statistically signifi
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sensitive K+-channels in vascular s
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clonidine (Catapres†) 0.1-0.8 mg
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Learning Objectives 204 Hypertensio
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general, the response to beta-block
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Table 2: (JNC VII, 2004) 208 Hypert
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Learning objectives: 210 Hypertensi
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ecently published RCT investigated
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Post-test question: 35y/o male w/ h
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Orthostatic Hypotension Pretest que
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BP. It is important to note that la
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1- Fludrocortisone : a mineralocort
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References: 1. Hiitola P, Enlund H,
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www.neuroanatomy.wisc.edu/.../Image
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Learning objectives: 226 Hypertensi
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controlled BP to have been victimiz
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Treatment of Secondary Causes of Hy
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4-Direct vasodilators (e.g.minoxidi
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Hypertension. Aug 2003;42(2):161-16
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emergency by virtue of the associat
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PATHOPHYSIOLOGY The underlying mech
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trials included a placebo arm. Seve
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an indication for careful and modes
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ACUTE KIDNEY INJURY (AKI) In additi
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Blood Pressure Research Council, an
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[ACE inhibitors (ACEIs), angiotensi
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y sodium restriction or the use of
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44 months 24 , and were also seen i
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• Hypertension in dialysis patien
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GISEN Group (Gruppo Italiano di Stu
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258 Hypertension Core Curriculum
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DEFINITION AND CLASSIFICATION Hyper
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etween adult socioeconomic position
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women treated with atenolol in earl
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Obstet Gynecol. Dec 12 2008. 5. Vol
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able to dissipate the pressure rise
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Use of Dihydropyridine Calcium Anta
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272 Hypertension Core Curriculum Ca
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Case 4 Hypertensive patient with CK
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Case 6 276 Hypertension Core Curric
Page 278 and 279:
year. Sodium restriction and weight
Page 280:
What may be causing these new sympt
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