HYPERTENSION MANAGEMENT

High blood pressure is the leading preventable cause of cardiovascular disease. We do not guess. We diagnose using home blood pressure monitoring (HBPM) and manage aggressively to target.

THE DIAGNOSTIC STANDARD

A single high reading in a clinic is not a diagnosis. Up to 30% of patients exhibit "white coat hypertension." Initiating medication based on isolated in-clinic data is malpractice.

Our protocol requires a validated, automated upper-arm cuff. You will take readings twice in the morning and twice in the evening for 7 days. We diagnose based on the average of these readings.

Target Metrics

According to the 2017 ACC/AHA guidelines, the goal for most adults is a sustained BP of < 130/80 mmHg.

Common Mistakes

Using wrist monitors, which are highly inaccurate compared to upper-arm cuffs.
Taking readings immediately after drinking coffee or exercising (must rest for 5 minutes prior).
Stopping medication abruptly because "numbers are normal now." (The medication is why the numbers are normal).

TREATMENT PROGRESSION

Phase	Intervention Strategy	Expected Reduction (Systolic)
1. Lifestyle Modification	DASH Diet, Sodium restriction (< 1500mg), Weight loss, Aerobic exercise	~10-20 mmHg per 10kg lost
2. First-line Pharmacotherapy	ACEi/ARB, Calcium Channel Blocker, or Thiazide diuretic based on patient profile	~10-15 mmHg per agent
3. Combination Therapy	Dual-agent therapy (often in a single pill) for Stage 2 or non-responders	Additive effects

FAQ: HYPERTENSION

Will I have to be on medication forever?

Not necessarily. If your hypertension is driven by lifestyle factors (weight, sodium, alcohol), significant modifications can normalize blood pressure, allowing us to safely taper medication. However, essential hypertension has a strong genetic component that often requires lifelong management.

Are there side effects to the medication?

All medications have potential side effects. For example, ACE inhibitors can cause a dry cough, while calcium channel blockers can cause mild ankle swelling. We select medications based on your specific profile to minimize these, and adjust rapidly if they occur.