Challenges in Cardiovascular Risk Modification: Blood Pressure

By Suzanne Hughes, MSN, RN  |  February 18, 2020  |  Emerging Medicine

Image of a blood pressure monitor

Partnering with patients to assess their risk for cardiovascular disease can be a challenge. Developing a plan of care to manage hypertension is individualized; incorporating patient buy-in sets the stage for optimal adherence with the therapeutic plan, which often includes recommendations for lifestyle changes (physical activity, heart healthy diet, maintenance of ideal weight) along with a medication regimen.

What’s New?

We recently learned more about sex differences in the development of hypertension. Researchers studied the sex differences in patterns of the development of hypertension by analyzing the data from 4 studies including over 30,000 men and women; longitudinal follow up spanned 40+ years. Compared with their male counterparts, when women developed hypertension, there was a steeper increase in BP readings, beginning in their 20’s and persisting throughout life.  The authors suggest that these steep increases in blood pressure (a marker of vascular aging) may underlie the sex differences in pathophysiology of heart disease and heart failure.[i] In addition, the findings reinforce contemporary efforts toward individualizing cardiovascular risk reduction efforts in women, and careful monitoring and management when hypertension is detected in younger women.

How can I use this information in my practice?

High blood pressure has more adverse cardiovascular consequences in women, but unfortunately, women with high blood pressure are less frequently treated to target goal than men. There is a great opportunity for clinicians to work with women to achieve optimal blood pressure through heart-healthy lifestyle changes and pharmacologic therapies.

In a K2P expert perspective module, Dr. Kristin Newby from Duke University School of Medicine provides her insights on the importance a patient-centered approach to hypertension management, and tips to improve adherence to complex regimens, particularly in patients who require multiple antihypertensive medications. K2P’s expert perspectives in the Current MD library embed pearls for practice by national thought leaders like Dr. Newby.

Explore Current MD Cardiology for more timely information to incorporate into your clinical practice today!

[i] Ji H, Kim AEbinger JE, et al. Sex differences in blood pressure trajectories over the life course. JAMA Cardiol. 2020 Jan 15. doi: 10.1001/jamacardio.2019.5306.

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