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Chapter 53. Renal Denervation: Pathophysiology, Techniques, and Clinical Data

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According the US Preventive Services Task Force (USPSTF), 15% to 30% of the population may have lower blood pressure outside of the office setting. The USPSTF recommends which of the following as the most evidence-based method of diagnosing hypertension?

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A. Ambulatory blood pressure monitoring (AMBP)

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B. Mean of 3 office-based blood pressure (OPB) measurements on different days

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C. Home blood pressure monitoring (HBPM)

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D. The mean of 2 OPB measurements taken while the patient was seated with at least 5 minutes between entry into the office and blood pressure measurement

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The correct answer is A

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The USPSTF recommends OBP as an initial screening. However, further evaluation with ABPM or HBPM is recommended to diagnose hypertension. According to the USPSTF, there is convincing evidence that AMBP is the best method for diagnosing hypertension and considers it the gold standard. Comparisons between OBP and HBPM have been less well studied.

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Patients with resistant hypertension are defined as which of the following?

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A. Patients with systolic blood pressure ≥160 mm Hg for >1 year despite antihypertensive therapy

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B. Patients whose blood pressure remains above goal despite adequate treatment with ≥3 different classes of antihypertensive agents, ideally including a diuretic

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C. Patients with systolic and diastolic blood pressure ≥180/100 mm Hg for 1 year after secondary causes have been excluded

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D. Patients with systolic and diastolic blood pressure ≥160/100 mm Hg for 1 year despite treatment with ≥2 different classes of antihypertensive agents

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The correct answer is B

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Patients with resistant hypertension, according to an American Heart Association consensus document, are defined as patients whose blood pressure remains above goal despite adequate treatment with 3 or more different classes of antihypertensive agents, ideally including a diuretic.

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Among hypertensives, what is the estimated prevalence of resistant hypertension ?

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A. 5% or less

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B. 5%-15%

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C. 15%-30%

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D. 30%-40%

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The correct answer is C

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Despite advances in our understanding of resistant hypertension and in pharmacologic treatment, the prevalence of true treatment-resistant hypertension is as high as 15% to 30% of treated hypertensive patients. In patients with hypertension and coronary artery disease, however, the prevalence of resistant hypertension is more than 30% ...

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