This activity consists of 3 “bundled” courses from SMA’s online library, and includes: The Hypertension Landscape in 2017: The NEW Guidelines are Here; Resistant Hypertension: The New Guidelines; and A Case-Based Update on Heart Failure: Focus on the 2017 Guidelines. The activity concludes with a series of case studies, highlighting the content.
If you select this bundle, please do not purchase the courses individually.
Goals and Objectives
The Hypertension Landscape in 2017: The NEW Guidelines are Here:
Nearly 1 in 3 Americans suffer from hypertension, making it the nation’s #1 most common medical condition. Only 58% of patients diagnosed with hypertension are receiving adequate treatment, therefore, physicians have the opportunity to recognize barriers and institute improvements for better outcomes. This activity will highlight the improvements in BP control rates, the proper way to take BP, definitions of white-coat and masked hypertension and the importance of out-of-office BP measurement. It will review the classes of antihypertensive drugs indicated for first-line treatment for hypertension and the differing targets for BP control based on the recent SPRINT trial. It will highlight efforts to improve current BP control rates to what can be achieved in the Kaiser Permanente Health Program when using their algorithm for BP control. Upon Completion, learners should be better prepared to:
- Understand the epidemiology of hypertension, recent improvements in BP control rates for hypertension, and the proper way to measure BP;
- Review the SPRINT trial and how it influenced the new HTN guideline dealing with BP targets recommended to improve CV and renal outcomes;
- Recognize which classes of antihypertensive agents are recommended as first-line agents in the treatment of hypertension.
Resistant Hypertension: The New Guidelines:
Approximately 10-30% of patients fail to have their BP controlled on three antihypertensive agents, one of which is a diuretic. Reasons for this apparent lack of BP control has to do with the office BP measurement itself, lack of adherence to drug therapy, and inappropriate combinations of antihypertensive medications that do not complement each other’s mechanism of action. This activity will review key secondary causes of hypertension including endocrine tumors, mineralocorticoid excess, and sleep apnea. A reasonable approach for those with resistant hypertension will be presented to further improve BP control rates in this high-risk population. Upon Completion, learners should be better prepared to:
- Understand the definition of resistant hypertension
- Review the clinical workup of resistant hypertension including the importance of 24-hr ABPM to secure the diagnosis
- Recognize the importance of lifestyle modification and the evidence for the use of chlorthalidone over hydrochlorthiazide, and mineralocorticoid receptor antagonism (spironolactone) as a 4th drug to improve BP control in those with resistant hypertension.
A Case-Based Update on Heart Failure: Focus on the 2017 Guidelines:
Heart failure is the leading cause of initial hospitalization and re-hospitalization within 30 days of discharge in those over 65 years of age. While the treatment of heart failure with reduced ejection fraction (HFrEF) remains evidence-based from clinical outcome trials, clinicians fail to use these strategies to keep patients from hospitalization and CV death. This activity will address this practice gap using patient vignettes to suggest how best to treat patients with heart failure. In addition, the concept of heart failure with preserved ejection fraction (HFpEF) will be discussed, where the evidence base for improvement in outcome is currently lacking and treatment is based on symptomatic improvement. Upon Completion, learners should be better prepared to:
- Discuss the current epidemiology of heart failure including its prevalence, increase with age, and ethnic disparities
- Describe the appropriate workup for patients with symptomatic heart failure including when and how to use Brain Natriuretic Peptide (BNP) and Pro-B-type natriuretic peptide (NT-proBNP)
- Recognize the differing treatments for those with heart failure with preserved ejection fraction (HFpEF) vs heart failure with reduced ejection fraction (HFrEF)
- Recognize the newer treatments for (HFrEF) including LCZ696 (valsartan/sacubitril) and ivrabradine and how they might be best used in treatment.
Cases in Hypertension and Heart Failure for the Primary Care Clinician:
After hearing didactic lectures on hypertension and heart failure, it is the intention of this lecture to guide the learners through actual cases relating to these topics. Initial history will be shown, and the audience will be asked, in an interactive fashion, to develop a differential diagnosis, diagnostic plan, and therapeutic strategy. This lecture will reinforce material already presented in previous days. Upon completion, learners should be better prepared to:
- Develop a differential diagnosis for real cases presented related to hypertension and heart failure.
- Develop a diagnostic plan to determine the correct etiology of the disorder illustrated.
- Develop a therapeutic strategy appropriate for the diagnosis.
CME Release Date: December 27th, 2017
Valid for credit through: December 27th, 2018
Course type: Video lecture
Sponsored in part by: SMA Services, Inc.
Southern Medical Association is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.
Southern Medical Association designates this enduring material for a maximum of 4.25 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
For information on applicability and acceptance of continuing education credit for this activity, please consult your professional licensing board. All healthcare professionals who are not MDs or DOs will receive a certificate of participation.
Instructions for Participation and Credit
This activity is designed to be completed within the time designated; learners should claim only those credits that reflect the time actually spent in the activity. To successfully earn credit, participants must complete the activity online during the valid credit period noted, following these steps:
- Read the goals and objectives, accreditation information, and author disclosures.
- Study the educational content and references.
- Online, choose the best answer to each test question. To receive a certificate, you must receive a passing score of 80%.
- Complete the activity evaluation and attestation.
Upon completion of the evaluation and attestation, your certificate will be processed and emailed within 2 weeks. Credits will be archived for 6 years; at any point within this time period you can contact Southern Medical Association for a duplicate copy of your credit.
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