AHA High Blood Pressure Toolkit-Pharmacists

2 Hypertension Guideline Toolkit for Pharmacists HIGHLIGHTS From the 2017 Hypertension Guideline that Will Impact Pharmacy 8 Things to Know 1 Blood pressure classifications have changed. The guideline establishes a new evidence-based classification of BP in adults, with hypertension defined by systolic and diastolic BPs that are lower than the previous thresholds. 2 The prevalence of hypertension in America is higher. Nearly half of all adults in the United States will have high BP under the updated classifications. 3 Treating high blood pressure begins with accurate measurements. Accurate measurement of BP is essential for categorizing BP, determining the risk of atherosclerotic cardiovascular disease and managing high BP. Diagnosis and management of hypertension should be based on accurate measurements not only in a doctor’s office but also through self-monitoring. 4 High BP could be the result of a secondary cause. Secondary causes are responsible for about 10% of high blood pressure cases. Many of these can either be cured or require specific treatments. 5 Lifestyle changes are a first line of treatment for many patients. Nonpharmacologic interventions aimed at addressing poor dietary habits, physical inactivity and/or excessive consumption of alcohol are fundamentally important in managing the underlying causes of high BP in most adults. 6 Medicine can help control high blood pressure when lifestyle changes are not enough. Pharmacists should discuss the importance of medication management and all prescription and over-the- counter medications with patients. 7 Four drug classes are recommended as first choice for patients with high blood pressure. They are thiazide diuretics, calcium channel blockers, angiotensin converting enzyme inhibitors and angiotensin receptor blockers. For many adults with high blood pressure, pharmacotherapy requires more than one agent or a combination of BP medicines. 8 Improving treatment and control of hypertension may require special consideration. Most adults receiving antihypertensive drug therapy have an average systolic BP and/or diastolic BP above the target level recommended in this guideline. Recommendations to improve treatment and control are provided for high blood pressure in adults with one or more comorbidities, or those who have resistant hypertension or a hypertensive crisis. Dispensing Advice Top 10 Things to Know