Description

In the final episode of our hypertension series, Taylor  and Dr. Gallagher discuss the causes of high blood pressure and management in special populations.

Share your reactions and questions with us at  Speak Pipe . We might feature you on a future episode!

=== Outline ===
1. Introduction
2. Chapter 1: Causes of Primary Hypertension
3. Chapter 2: Secondary Hypertension
4. Chapter 3: Treating Hypertension in Special Populations
6. Conclusion

=== Learning Points ===

1. About 90% of patients with hypertension experience primary hypertension. About 10% of patients with hypertension experience secondary hypertension due to an underlying disease or interfering medication. Causes of secondary hypertension can include pheochromocytoma, renal artery stenosis, CKD, primary hyperaldosteronism, fibromuscular dysplasia, and obstructive sleep apnea.
2. Workup for diagnosing the cause of hypertension should include a detailed history and a focused physical exam. Basic labs should include assessment for acute nephritis (e.g. hematuria, pyuria, or proteinuria), lipid panel, and A1C to screen for type 2 diabetes. 
3. “Hypertensive urgency” is differentiated from forms of hypertensive emergency by the absence of hypertensive end organ damage. Distinguishing between the two conditions is key for determining the therapeutic goal for blood pressure.
4. Patients who are elderly, pregnant, may become pregnant, or have chronic kidney disease require special attention and management of their hypertension.

=== Our Expert(s) ===

Benjamin Gallagher, MD, FACP is an Assistant Professor of Clinical Medicine (General Medicine) at Yale School of Medicine.

=== References ===

de la Sierra A, Segura J, Banegas JR, Gorostidi M, de la Cruz JJ, Armario P, Oliveras A, Ruilope LM. Clinical features of 8295 patients with resistant hypertension classified on the basis of ambulatory blood pressure monitoring. Hypertension. 2011 May;57(5):898-902. doi: 10.1161/HYPERTENSIONAHA.110.168948. Epub 2011 Mar 28. PMID: 21444835.

Anderson TS, Jing B, Auerbach A, et al. Clinical Outcomes After Intensifying Antihypertensive Medication Regimens Among Older Adults at Hospital Discharge. JAMA Intern Med. 2019;179(11):1528–1536. doi:10.1001/jamainternmed.2019.3007

=== About Us ===

The Primary Care Pearls (PCP) Podcast is created in collaboration with faculty, residents, and students from the Department of Internal Medicine at the Yale School of Medicine. The project aims to create accessible and informative podcasts about core primary care topics centered around real patient stories.

Hosts: Josh Onyango, Maisie Orsillo
Producers: Helen Cai, Kevin Wheelock, Danish Zaidi
Logo and name: Eva Zimmerman
Theme music and Editing: Josh Onyango
Other background music: Coma Media, Defekt_Maschine, Chris Haugen, Unicorn Heads, and Slynk.

Instagram: @pcpearls
Twitter: @PCarePearls
Listen on most podcast platforms: linktr.ee/pcpearls