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High Blood Pressure? Vanderbilt Hypertension Clinic Can Help
High blood pressure increases risk for stroke and heart disease. Dr. Cheryl Laffer, Director of Vanderbilt Hypertension Clinic, discusses disease prevalence and how the Hypertension Clinic can provide services to help.
Nic Gonzales: Welcome to this edition of the Vanderbilt University Health and Wellness Wellcast. I am Nic Gonzales with Health Plus.
I am here today with Cheryl Laffer, professor of Medicine for the Division of Clinical Pharmacology. Today, we will be talking about hypertension and the Hypertension Clinic. Cheryl, tell me a little about hypertension and how common it is.
Cheryl Laffer: It is the most common cardiovascular disease in the western world, and in the US, probably a third of adults have it. It is number one reason for an adult to go see their doctor actually. So, it is very common. There are nearly 80 million Americans that are diagnosed with hypertension which means high blood pressure.
Nic Gonzales: Wow, that is a lot of people. How many people actually have hypertension are aware that they have it?
Cheryl Laffer: Fortunately, more than half a people who have it now know that they have it. Awareness levels have gone up over the years. There is a survey that goes out every couple of years that actually asks people are they taking medicine for high blood pressure and do they know that they have it, etc., and that survey has actually shown that they have better knowledge and awareness, and also, there are more people on treatment than previously, but the numbers of people with hypertension keep going up because we get older and more obese as a society and that is a factor for hypertension.
Nic Gonzales: Lot of people that have it really do not even know they have it. So, for the ones that do have it and know about it what are the most important things to keeping it under control?
Cheryl Laffer: The most important thing of course is to talk to their doctor about it, and they can also measure their blood pressure at home, which is very useful because just getting one reading in the office does not give us as much information as checking it at home. So, being aware of it, taking the medicines that their doctor prescribes, letting their doctor know if they are having any trouble with their medicines, and then bringing in numbers from home can be very helpful.
Nic Gonzales: I can’t believe the high blood pressure is so common. You have so many people who have difficulty controlling it or are even unaware they even have it. So, tell me little about the Hypertension Clinic and how I can partner with patients and their providers in treating hypertension.
Cheryl Laffer: Yeah, the Hypertension Clinic in Vanderbilt obviously cannot see every patient who comes to Vanderbilt with hypertension since that would be approximately a third of the adults and probably even more in the hospitalized population. What we see are the patients who cannot be taken care of by their local doctor. Largely, that is a matter of they need more medicine than their doctor is comfortable giving them. So, for example, the patient is on more than three different medicines for blood pressure and not controlled, then they should probably come see us. That is the definition of resistant hypertension meaning that their blood pressure cannot be controlled with three medications, which one is what we call a diuretic or colloquially it is called the water pill. So, that is the definition. Those people should definitely come see us because we should look and see if there is an underlying cause of their high blood pressure. If not, then we just arrange their medicines in a way that makes it easier for them to take them and send them back to their doctor.
Nic Gonzales: Are certain people eligible for it or how do they get started with Hypertension Clinic?
Cheryl Laffer: Oh, anyone can come see us. We are happy to see anyone at all. I just said the definition of resistant hypertension as a good reason to come see us or if they are having a lot of trouble with medicines. So, their doctor is kind of frustrated with not being able to give them medicine that they can take. It is another good reason to come see us. We are more familiar with the different medicines. There are over 100 medicines out there for treatment of hypertension. So, if they are having trouble with the medication, that is another good reason to see us. A third reason is someone who thinks that their blood pressure is well controlled except when they go to the doctor, so they think they have the white coat syndrome, and that is really not all that common. Everyone’s blood pressure will be a little higher in the office than it is at home, but if they check their blood pressure at home and they check it accurately, we can use that information to titrate their medicines. If they still cannot diagnosed that way, we can actually do what is called an ambulatory blood pressure monitoring. It is a little machine that they wear for 24 hours, and it measures their blood pressure every 15 minutes. We look at that average and compare it to what we get in the office. If there is a significant difference, then we say yes you may have white coat hypertension, but we may still need to treat you.
Nic Gonzales: Thank you so much for meeting with me today. For anyone who is interested in visiting the Hypertension Clinic, it is located on the 2nd floor in TVC, part of the Medical Specialties Building, and if interested, just call 322-3353.
Thanks for listening. Please feel free to leave us any comments on this Wellcast on the form at the bottom of this page. If you have a story or suggestion, please email it to us at firstname.lastname@example.org or you can use the “Contact Us” page on our website at healthandwellness.vanderbilt.edu.
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