michigan hypertension core curriculum - State of Michigan

Hypertension Management Controversies
Low Diastolic Blood Pressure Should Prevent Antihypertensive Drug Therapy of Systolic
Hypertension (J-Curve Debate)........pp. 271
Use of Dihydropyridine Calcium Antagonists in Chronic Kidney Disease........pp. 274
Case Studies........pp. 276
1. A hypertensive patient taking multiple antihypertensive medications with poor BP control without an
appropriate diuretic prescribed.
2. A well controlled hypertensive patient with refractory hypokalemia despite replacement
3. A hypertensive patient with diabetes who is taking a diuretic and the steps that can be taken to
minimize or prevent diuretic induced hyperglycemia.
4. Hypertensive patient with CKD with poorly controlled BP control experiencing a significant elevation
in creatinine when BP is lowered below his goal BP.
5. A hypertensive patient who is being treated with multiple antihypertensive drugs who has significant
orthostatic hypotension.
6. A hypertensive patient with truly resistant hypertension.
7. A hypertensive patient with CKD and heavy proteinuria.
8. A hypertensive patient with CKD, and proper use of diuretics appropriate to level of renal function.
9. Ms. LN returns 2 weeks after addition of an ACE-I and diuretic, and lab results reveal a reduction in
EGFR. What may be the cause of the reduction in renal function, and how would you handle?
10. Ms. LN returns 4 weeks after addition of an ACE-I and diuretic, and is symptomatic. What may be
causing these symptoms, and how would you handle?
NKFM & MDCH 9