What are the major changes in the new guidelines?

What are the major changes in the 2017 guidelines?

What is Normal Blood Pressure?

Risk-Based Blood Pressure Targeting

Why did the committee move the bar down?

What do we do with white coat hypertension?

What about the very old individual with very high systolic and low diastolic blood pressure?

How low should the diastolic blood pressure be?

What is Masked Hypertension

How rigorous were the guidelines?

Welcome

Thresholds for drug treatment

Population Impact of 2017 Guidelines

Secondary Hypertension

Dietary Recommendations for Hypertension

Thiazide-like diuretics vs thiazide diuretics

Effects of Intensive Blood Pressure Therapy on Cognitive Impairment and Dementia

Primary aldosteronism diagnosis

Closing Remarks

Summary

Differences in Blood Pressure Classification

Blood pressure treatment thresholds

Essential vs. Optimal Approach

Major Differences Between ISH and AHA/ACC Guidelines

Grade 1 Hypertension

Stage/Grade 2 Hypertension

Update on the Most Recent 2017 ACC/AHA Guideline on Hypertension

BP AND RISK OF CARDIOVASCULAR DISEASE

HTN Prevalence Based on New Thresholds and NHANES 2011-2014.

The Promise of Automated Office Blood Pressure (Oscillometric) Monitors

Randomized Trials- Non-pharmacological interventions

Initiation of Antihypertensive Medication- Recommendation in the 2017 ACC/AHA Guideline

Choice of Initial Medication

Rationale for Lowering the BP Levels Used to Define Hypertension in the ACC/AHA Guideline

Randomized Controlled Trials of Intensive vs. Standard BP Targets for Diabetes Mellitus

Take Home Messages

Objectives

Blood Pressure and Cardiovascular Risk

Measuring Blood Pressure in Adults

Blood Pressure Categories

Summary of Lifestyle Modification

What to do at different blood pressure levels

Meta-Analysis of Accord and SPRINT Trials

Chronic Kidney Disease

Importance of Informed Patient and Clinician Decision Making

What is masked uncontrolled hypertension?

THE EIGHTH JOINT NATIONAL COMMITTEE (JNC 8)

SYSTOLIC BLOOD PRESSURE INTERVENTION TRIAL- (SPRINT)

AMERICAN COLLEGE OF CARDIOLOGY/ AMERICAN HEART ASSOCIATION (ACC/AHA)

Guideline on Resistant Hypertension

Controlled Resistant Hypertension

Improper Blood Pressure Measurement

Dner Hypertension Trial

Corticoid Antagonists

How Important Is It To Differentiate Pseudo Resistant or Apparent Resistant Hypertension from True Resistant Hypertension

Sodium and Volume Overload

Resistant Mineralocorticoid Receptor Antagonism

History of Hypertension

Beta Blocker

What is the Optimal Level of Blood Pressure Control?

Benefits of Blood Pressure Reduction

Threshold and Treatment Blood Pressure Levels

High-Risk Patients

European Hypertension Guidelines

Threshold and Target Blood Pressure Levels

Scientific Evidence Supporting Lower Blood Pressure Levels

Optimal Target Blood Pressure

Epidemiology of Hypertension

Early vs Late Onset Hypertension

Background

What are the differences from the old guidelines?

What is the goal of treating pediatric hypertension?

Definitions and categories of pediatric hypertension

Screening table

How do we screen for pediatric hypertension?

Nutrition and weight management referral

Action statements for pediatric hypertension

Key takeaways

Conclusion

What is primary prevention?

What is new about these guidelines?

What is the most important way to prevent cardiovascular disease?

What is the role of statins in the primary prevention of cardiovascular disease?

What are risk-enhancing factors to consider when making a statin decision?

What is a coronary artery calcium score?

Who should be on a statin regardless of 10-year risk?

What is new with aspirin?

Closing thoughts

Introduction

Non-pharmacological interventions to lower blood pressure

Determining for whom pharmacotherapy is indicated

Prescribing guideline-recommended anti-hypertensive medications