Continuing Medical Education (CME)

Hypertension: Essential Hypertension in Adults (Non-Pregnant) 

Introduction to this self-study CME activity

Purpose

Approximately 25% of adults in the United States adults have elevated hypertension. Half of these people have no medication prescribed, and half of the people on medication are not controlled. Uncontrolled hypertension results in end stage organ damage, which leads to significant mortality and morbidity. The purpose of this educational activity is to help clinicians (1) accurately diagnose hypertension, (2) improve blood pressure (BP) control, (3) decrease hypertension-related morbidity and mortality, (4) encourage patient’s self-involvement, (5) provide appropriate education and follow-up, and (6) provide cost-effective care.

New aspects of care addressed in this update include:

• ACE inhibitors have been shown to improve outcomes, particularly for patients with diabetes, and are appropriate initial therapy for most patients.
• Target blood pressure should be 135/80 mm Hg for patients with diabetes, renal disease, cardiovascular disease, or cerebrovascular disease.

Key aspects of care are:

• Diagnosis is best achieved by taking mean BP levels over several visits, and careful calibration of the BP monitor.
• Target BP therapy is 140/90 mm Hg or less for patients without diabetes or renal insufficiency and is 135/80 mm Hg or less for patients with diabetes, renal disease, cardiovascular disease or cerebrovascular disease.
• Thiazide diuretics, ACE inhibitors, and beta-blockers are preferred for initial drug therapy.
• Patient education and self-management is fundamental to successful therapy.

Audience

This self-study activity is appropriate for primary care clinicians and other health care providers who diagnosis and treat hypertension in non-pregnant adults.

Authors

Team Members
	William Barrie, MD General Medicine Janice Stumpf, PharmD Pharmacy Kenneth Jamerson, MD Hypertension Philip Zazove, MD Family Medicine
Consultant
	Lee Green, MD, MPH Family Medicine
Author Disclosures
	Team Member Company Relationship William Barrie, MD None   Kenneth Jamerson, MD Novartis Grant, Consultant   Solvey Consultant   BMY Shareholder Janice Stumpf, PharmD Bristol-Myers Squibb Shareholder Philip Zazove, MD None

Other Acknowledgements

UMHS Guidelines Oversight Team: William E. Chavey, MD R. Van Harrison, PhD Connie J. Standiford, MD Literature search services: Taubman Medical Library Production of Internet format and web site maintenance: Ellen Patrick-Dunlavey, MA

CME Accreditation and Credit Designation

The University of Michigan Medical School is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

The University of Michigan Medical School designates this educational activity for a maximum of 1 AMA/PRA Category 1 Credits™.  Physicians should only claim credit commensurate with the extent of their participation in the activity.

This CME activity was released in April 2003, with credit available through April 2005.  This activity was reviewed for currency of content in May 2006 and availability of credit extended through April 2008.  This activity was again reviewed for currency of content in April 2008 with credit extended through April 2009.

Method of Participation

1. View the web pages. You may print the self-study text to read off-line.
2. Complete the on-line learning assessment test.  It will be electronically scored and the correct answers returned immediately for your review.
3. Complete the electronic credit request and activity evaluation.  An electronic certificate of participation will be provided immediately.
4. Print the certificate of participation for your personal records.

 

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