Cardiovascular Essentials for Advanced Practice Providers-Hypertension and Hyperlipidemia

Video Transcription
Video Summary
In this video, Ginger Biesbrach discusses screening recommendations, guidelines, and management for hypertension and hyperlipidemia. When it comes to screening recommendations for hypertension, adults above 40 should be screened annually, while those at risk or with blood pressure readings of 130-139/85-89 mmHg should also be screened annually. For adults aged 18-40 with no risk factors, screening can be done every three to five years. Hypertension can lead to end organ damage such as aortic disease, microvascular disease, heart disease, kidney damage, and stroke. Guidelines for blood pressure classification emphasize that elevated blood pressure is greater than 120-129/less than 80 mmHg, while stage one hypertension is 130-139/80-89 mmHg. The target blood pressure for all adults is now less than 130/80 mmHg. Symptoms of hypertension can include headache, necturia, and vision changes. Physical exam findings may reveal signs of end organ damage. Management recommendations suggest using two or more antihypertensive medications to achieve blood pressure less than 130/80 mmHg. The choice of medication depends on comorbidities. Shifting to hyperlipidemia management, lifestyle changes should always be emphasized. For patients with atherosclerotic heart disease, LDL-C should be reduced with high-intensity statins or maximally tolerated statins. The threshold for considering non-statins with statins is an LDL-C of 70. Patients with severe primary hypercholesterolemia should be treated with high-intensity statins, regardless of atherosclerotic disease. Adults aged 40-75 with diabetes and an LDL greater than 70 should start moderate-intensity statins. Clinician-patient risk discussion is recommended before starting statin therapy for adults 40-75 without diabetes, with an LDL greater than or equal to 70, and a 10-year atherosclerotic risk greater than or equal to 7.5%. Measurement of calcium score can be considered if a decision about statin therapy is uncertain. Adherence and response to medication and lifestyle changes should be assessed regularly through lipid measurements. The video provides additional guidelines and recommendations for different scenarios. Atorvastatin 80 and rosuvastatin 40 are options for high-intensity statin therapy, while moderate and low-intensity statin options are also available.
Keywords
screening recommendations
hypertension management
hyperlipidemia management
blood pressure classification
statin therapy