Unmet Needs in Hypertension Treatment

Resistant hypertension affects twenty percent of all hypertensive patients.  It is the source of much cardiovascular risk and its ultimate sequela.  To this end innovative mechanisms of addressing this problem have and are being developed.  One of these is renal denervation of the sympathetic system.  Our guests on the podcast compare clinical studies and share success stories for treatment of resistant hypertensive patients. 

Managing hypertension is complex as you consider aspects of taking multiple medications, making lifestyle changes with diet and physical activity, and learning self-monitoring of blood pressure at home. As supported by guideline recommendations, team-based care among multidisciplinary healthcare professionals is important to optimize blood pressure control. Our discussion focuses on the experience at the Trinity Free Clinic in Carmel, Indiana in which a multidisciplinary team successfully manages patient hypertension.

Weight management, physical activity, and a heart-healthy diet are key behaviors in managing blood pressure and essential to lifelong good health. What role do clinicians play in shared decision making discussions with hypertensive patients around daily lifestyle decisions. What steps can clinicians take in providing guideline informed hypertension management that is equitable. Listen as a cardiologist and two nephrologists share their experiences and consider how to help patients address behavior modification barriers for those living with hypertension. 

Home blood pressure monitoring is informative but inaccessible for some outside of strengthened clinical support. Current guidelines comprehensively address how to define, measure, and treat high blood pressure, and yet hypertension management in special patient populations has not been systematically addressed.

Listen and learn how clinicians can utilize shared decision-making to better engage patients in their health care and support improved health equity.

While patients may have different goals and preferences for treatment, which can make selecting the best hypertension management plan difficult, adherence may be increased if the plan aligns with the patient’s preferences. What approaches in shared decision-making may improve adherence?

In this episode clinicians and a patient discuss changes in terminology when talking about patient compliance to the use of adherence and non-adherence. These changes are part of the larger shift to shared decision-making in patient care. Listen and learn how to employ shared decision-making across a range of care settings.

Renal denervation in the management of hypertension in adults has yet to be approved in the US, however, it is under FDA review. This procedure may be useful for adults with uncontrolled or resistant hypertension (triple drug therapy, one of which is a diuretic) and may be an option for patients unable to tolerate long-term medications at the necessary doses, or who cannot tolerate medications at all. With many factors to consider, hear a balanced discussion on this topic, as well as considerations from the patient perspective.