Thursday, June 11, 2015

Forum Test

This is a test post to see if having a discussion about clinical questions would work in this format.  If you wouldn't mind, answer the following question below.  Hopefully we will have more detailed and challenging cases in the future.

What is the preferred antihypertensive of choice for a 45 year old African American with a BP that is consistently 148 / 92?
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15 comments:

  1. AnonymousJune 11, 2015 at 3:36 PM

    Calcium channel blocker

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    1. RuchiJune 11, 2015 at 4:00 PM

      YAY! I was correct :D Gimme my license now

      Delete
  2. ace.harrisJune 11, 2015 at 3:38 PM

    Correct! Does anyone know why CCB over ACEI or ARB?

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  3. UnknownJune 11, 2015 at 3:40 PM

    Research has shown ACEI don't work as well in African Americans. Why wouldn't thiazide be your first line choice? I'm asking because that is what I would have gone with.

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  4. UnknownJune 11, 2015 at 3:44 PM

    I'll add on to the question... Who would you not give a calcium channel blocker to? Don't know if this is what you had in mind, Aaron but I can delete this if it's going the wrong direction.

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    1. ace.harrisJune 11, 2015 at 3:46 PM

      This is good. We could just call each other and discuss it, haha. Hopefully others will get involved.

      Delete
    2. UnknownJune 11, 2015 at 3:58 PM

      I'm lost without a "like" button

      Delete
    3. ace.harrisJune 11, 2015 at 4:03 PM

      Aren't you supposed to avoid CCBs in CHF? I can't remember why, but I think thats it.

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    4. ace.harrisJune 11, 2015 at 4:12 PM

      Looked it up to clarify. It's just non-vasoselective CCBs like diltiazem and verapamil that you should avoid in systolic HF

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    5. UnknownJune 11, 2015 at 5:59 PM

      Yeah, that is were I was going. Edema is something I've started taking into consideration with CCBs

      Delete
  5. ace.harrisJune 11, 2015 at 3:45 PM

    You'd be good to go with Thiazide as well. Thiazides and CCBs were more effective in cerebrovascular, HF, and cardiac outcomes. CCBs conferred a much lower stroke risk than ACEI and ARBs

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  6. AnonymousJune 11, 2015 at 3:56 PM

    I would say ACEi if he's got the diabeetus. African Americans and the elderly have a lower baseline plasma renin activity to begin with than other populations, which tends to make CCB's or diuretics more effective.

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  7. UnknownJune 11, 2015 at 5:10 PM

    Diet and wt. loss...

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    1. UnknownJune 11, 2015 at 6:00 PM

      Good luck with compliance on that one, hahaha

      Delete
  8. UnknownJune 17, 2015 at 6:23 PM

    lol nvm!!! i just read the top of the post that this is a "forum test". ignore my comment

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