Journal of Urgent Care Medicine

New Treatment for Pulmonary Arterial Hypertension

Last week, the Food and Drug Administration approved the medication sotatercept, which traps activins that cause constriction of arteries in the lungs, leading to pulmonary arterial hypertension (PAH). Sotatercept targets a growth factor that is overproduced in PAH, reducing the risk of blood vessel thickening. The population with PAH is relatively small—diagnosed in 500 to 1,000 Americans annually and disproportionately affecting women between the ages of 30 and 60, according to the American Lung Association. …

ACE Inhibitors Show Less Protection Against Stroke Mortality

In a study presented in JAMA Network Open, researchers sought to determine the difference in the long-term risk of mortality and morbidity outcomes for adults with hypertension taking a thiazide-type diuretic, calcium channel blocker (CCB), or angiotensin-converting enzyme (ACE) inhibitor. Their secondary analysis found that mortality due to cardiovascular disease was similar among patients, regardless of which treatment was used. However, compared with the diuretic group, the ACE inhibitor group had a 19% increased risk …

If One Spouse Has Hypertension, The Other Spouse May Have It Too

A recent study compared the concordance of hypertension within heterosexual couples and found that in as many as 47% of all hypertension cases, when one spouse has hypertension, so does the other spouse. Within the 4 countries studied, researchers observed a high overall prevalence of hypertension, ranging from 40% to 65% for both wives and husbands separately. At the same time, they observed a high prevalence of spousal concordant hypertension, ranging from 20% to more …

Implementing Clinical Practice Guidelines in Adults with Hypertension: An Effective Practice Change in Urgent Care

Urgent message: Too often, patients first learn that they have hypertension secondary to an unrelated presenting complaint—often, in the urgent care setting. Improving adherence to treatment guidelines may improve management and, ultimately, outcomes. Jennifer Iacovo, DNP, APRN, FNP-C; Bonni Cohen, PhDc, DNP, APRN, ANP-C, FNP-C, CHFN, CNE, FAANP; and Judith Butler, DNP, CNM, WHNP, CNE Abstract Background: There are approximately 100 million adults in the U. S. with hypertension (HTN); almost half go undiagnosed. The …

Clinical Challenge: July/August, 2011

The patient is a 37-year-old female who presents with a history of long-standing hypertension and diabetes mellitus. She had recently started on a new diuretic and felt very weak and light-headed. Her blood pressure was 88/56 mmHg with a pulse of 44 beats per minute. View the patient’s ECG (Figure 1). Consider the type of diuretic is she likely to be taking and what your next steps would be. Resolution of the case is described …

Management of Hypertensive Urgency in an Urgent Care Setting

Urgent message: Effective management of patients presenting to urgent care with acute high blood pressure starts with differentiating between hypertensive emergency and hypertensive urgency and ends with appropriate treatment and counseling. Sanjeev Sharma, MD, Christy Anderson, PharmD, Poonam Sharma, MD, and Donald Frey, MD Introduction Urgent care physicians routinely encounter patients with high blood pressure, but management – particularly for those patients with precarious elevations – remains controversial. Alternative options involve the use of various …