html5-img
1 / 15

Hypertension

Hypertension. Nick Price 22.8.07. Aim . Consider the application of ‘evidence based practice’ in the management of hypertension in primary care. EBP – defined as the integration of best available research evidence with clinical expertise and patient values (Sackett et al, 2000). Objectives.

clarissa-verne
Download Presentation

Hypertension

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Hypertension Nick Price 22.8.07

  2. Aim • Consider the application of ‘evidence based practice’ in the management of hypertension in primary care. • EBP – defined as the integration of best available research evidence with clinical expertise and patient values (Sackett et al, 2000)

  3. Objectives • Brief overview of NICE guidelines • Consider what this means in practice using some examples from patients • Become familiar with cardiac risk calculations and to be able to interpret what these mean. • Be able to explain this to patients

  4. So what is hypertension all about?

  5. Disease Orientated Outcomes

  6. Patient Orientated Outcomes

  7. Others’ Orientated Outcomes • GPs • Practice nurses • PCTs • Secondary Care • Patient groups (e.g. BHF) • Professional groups (e.g. BHS) • Drug Companies • Government

  8. What is hypertension? • > 140/90 ? • > 180/110 ? • > 160/100 or 160/ or 140/90 and 10 year CVD risk of > 20% or has end organ damage (NICE 2006)

  9. Measurement considerations • Techniques • No of readings • Cuffs • Home BP • Ambulatory

  10. Investigations (order of priority??) • Urine dipstix • U+E, creatinine (eGFR?) • TC + HDL • ECG

  11. Rx? • (Smoking) • (Low fat diet) • Exercise or physical activity • Low salt diet • Low alcohol • Low caffeine • Relaxation? • Types of fat?

  12. Cardiac Risk Assessments http://www.cvhealth.ed.ac.uk/othercalcs/cardiacrisk.html http://www.patient.co.uk/showdoc/40000133/ http://www.epi.bris.ac.uk/CVDethrisk/

  13. Involving patients

  14. Oh, OK then have some drugs! • < 55yrs A • > 55 or black patients C or D A+C or A+D A+C+D

  15. Summary – think carefully • Measurements • Interventions • Explaining to patients • Empowering vs disempowering patients • Use risk calculators • Non drug Rx is probably at least as effective as a whole stack of medication • Integrate your patients values into the management plan. • Don’t be bullied by QoF etc.

More Related