michigan hypertension core curriculum - State of Michigan

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References: 1. Association AD. All About Diabetes. http://www.diabetes.org/about-diabetes.jsp. Accessed July 27, 2009. 2009. 2. Higashino H, Miya H, Mukai H, et al. Serum nitric oxide metabolite (NO(x)) levels in hypertensive patients at rest: a comparison of age, gender, blood pressure and complications using normotensive controls. Clin Exp Pharmacol Physiol 2007;34:725-31. 3. Mokdad AH, Bowman BA, Ford ES, Vinicor F, Marks JS, Koplan JP. The continuing epidemics of obesity and diabetes in the United States. Jama 2001;286:1195-200. 4. Hillier TA, Pedula KL. Complications in young adults with early-onset type 2 diabetes: losing the relative protection of youth. Diabetes Care 2003;26:2999-3005. 5. Epstein M, Sowers JR. Diabetes mellitus and hypertension. Hypertension 1992;19:403-18. 6. Ashraf K, Raza SS, Ashraf O, Memon W, Memon A, Zubairi TA. Renal lymphangiectasia. British Journal of Radiology 2007;80:e117-8. 7. Krauss RM, Winston M, Fletcher RN, Grundy SM. Obesity: impact of cardiovascular disease. Circulation 1998;98:1472-6. 8. Black SA. Diabetes, diversity, and disparity: what do we do with the evidence? Am J Public Health 2002;92:543-8. 9. Verdecchia P, Reboldi G, Angeli F, et al. Adverse prognostic significance of new diabetes in treated hypertensive subjects. Hypertension 2004;43:963-9. 10. Peppa M, Uribarri J, Vlassara H. Advanced glycoxidation. A new risk factor for cardiovascular disease? Cardiovasc Toxicol 2002;2:275-87. 11. Peppa M, Uribarri J, Vlassara H. Glucose, Advanced Glycation End Products and Diabetes Complications: What is New and What Works. Clinical Diabetes 2003;21:186-7. 12. Stamler J, Vaccaro O, Neaton JD, Wentworth D. Diabetes, other risk factors, and 12-yr cardiovascular mortality for men screened in the Multiple Risk Factor Intervention Trial. Diabetes Care 1993;16:434-44. 13. Folsom AR, Wu KK, Rosamond WD, Sharrett AR, Chambless LE. Prospective study of hemostatic factors and incidence of coronary heart disease: the Atherosclerosis Risk in Communities (ARIC) Study. Circulation 1997;96:1102-8. 14. Turner RC, Millns H, Neil HA, et al. Risk factors for coronary artery disease in non-insulin dependent diabetes mellitus: United Kingdom Prospective Diabetes Study (UKPDS: 23). Bmj 1998;316:823-8. 15. U.S. Renal Data System, USRDS 2006 Annual Data Report: Atlas of End-Stage Renal Disease in the United States. In: National Institutes of Health NIoDaDaKD, Bethesda, MD, 2006, ed.; 2006. 16. Haffner SM, Lehto S, Ronnemaa T, Pyorala K, Laakso M. Mortality from coronary heart disease in subjects with type 2 diabetes and in nondiabetic subjects with and without prior myocardial infarction. N Engl J Med 1998;339:229-34. 17. Watkins PJ. UKPDS: a message of hope and a need for change. United Kingdom Prospective Diabetes Study. Diabet Med 1998;15:895-6. 18. Nathan DM. Some answers, more controversy, from UKPDS. United Kingdom Prospective Diabetes Study. Lancet 1998;352:832-3. 19. Bretzel RG, Voigt K, Schatz H. The United Kingdom Prospective Diabetes Study (UKPDS) implications for the pharmacotherapy of type 2 diabetes mellitus. Exp Clin Endocrinol Diabetes 1998;106:369-72. 20. Curb JD, Pressel SL, Cutler JA, et al. Effect of diuretic-based antihypertensive treatment on cardiovascular disease risk in older diabetic patients with isolated systolic hypertension. Systolic Hypertension in the Elderly Program Cooperative Research Group. Jama 1996;276:1886-92. 21. Chaturvedi N. HOPE and extension of the indications for ACE inhibitors? Heart Outcomes Prevention Evaluation. Lancet 2000;355:246-7. 22. Effects of ramipril on cardiovascular and microvascular outcomes in people with diabetes 62 Hypertension Core Curriculum
mellitus: results of the HOPE study and MICRO-HOPE substudy. Heart Outcomes Prevention Evaluation Study Investigators. Lancet 2000;355:253-9. 23. Brenner BM, Cooper ME, de Zeeuw D, et al. The losartan renal protection study--rationale, study design and baseline characteristics of RENAAL (Reduction of Endpoints in NIDDM with the Angiotensin II Antagonist Losartan). J Renin Angiotensin Aldosterone Syst 2000;1:328-35. 24. Bakris GL, Weir MR, Shanifar S, et al. Effects of blood pressure level on progression of diabetic nephropathy: results from the RENAAL study. Arch Intern Med 2003;163:1555-65. 25. Lewis EJ, Hunsicker LG, Clarke WR, et al. Renoprotective effect of the angiotensin-receptor antagonist irbesartan in patients with nephropathy due to type 2 diabetes. N Engl J Med 2001;345:851- 60. 26. Shaw K, Gennat H, O'Rourke P, Del Mar C. Exercise for overweight or obesity. Cochrane Database Syst Rev 2006:CD003817. 27. Mogensen CE. Drug treatment for hypertensive patients in special situations: diabetes and hypertension. Clin Exp Hypertens 1999;21:895-906. 28. 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. 29. Fioretto P, Bruseghin M, Berto I, Gallina P, Manzato E, Mussap M. Renal protection in diabetes: role of glycemic control. J Am Soc Nephrol 2006;17:S86-9. NKFM & MDCH 63
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MICHIGAN HYPERTENSION CORE CURRICUL
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April 2010 Dear Colleague: In 2005,
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Kevin L. Piggott, MD, MPH, FAAFP Pr
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Blood Pressure Measurement........
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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 48 and 49: References: 1. U.S. Renal Data Syst
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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 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
Page 98 and 99: Definition Prevalence Clinical Feat
Page 100 and 101: intake. 4 Figure 1; Ion transport i
Page 102 and 103: loading with 200 mmoles (4.6 grams)
Page 104 and 105: Figure 3; Endocrine Society See tex
Page 106 and 107: INTRODUCTION 106 Hypertension Core
Page 108 and 109: Renal manifestations. Renal ischemi
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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
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What may be causing these new sympt
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