Our Evidence-based Protocol to Control High Blood Pressure
Better blood pressure control for less money
Achieving blood pressure control to less than 140/90 in 85-90% of patients is very easy with this protocol. You simply start with losartan/ hydrochlorothiazide and go through the steps until the blood pressure is less than 140/90. If you go through all three steps, and the blood pressure is still high, repeat the steps and double the dose until the blood pressure is controlled. If your own blood pressure is not controlled to 140/90 or less, get in touch with your doctor for a change in treatment.
High blood pressure, also known as hypertension, is the most important risk factor for cardiovascular diseases. If you are an individual with high blood pressure or if you are a clinician who treats high blood pressure, an evidence-based protocol is critical to provide the best hypertension control at the lowest cost. This is a critical issue. High blood pressure is the easiest cardiovascular risk factor to control, but only 44% of Americans with high blood pressure have their readings reduced to a level under 140/90. That failure leads to thousands of people needlessly having congestive heart failure, chronic kidney disease, heart attacks, and strokes.
Hypertension is much more common than other major risk factors like diabetes, high cholesterol, and smoking. High blood pressure has the strongest evidence that it causes vascular events. It is responsible for an estimated 47% of acute heart events and 54% of strokes.
Controlling hypertension in 85-90% of our patients to a blood pressure of <140/90 is easy using our hypertension protocol. As with any systematized quality improvement in medicine, this approach does not fit everyone, but it does enable better management of 80 to 90 percent of patients with hypertension. Protocols reduce confusion in patients by eliminating variation. It can dramatically improve your hypertension control rates. Nurse practitioners and phamacists on teams do this work best. Best of all, this systematic approach to high blood pressure control can be standardized and scaled. It dramatically improves clinical and financial outcomes when it is part of an integrated optimal medical therapy protocol that addresses diabetes and high cholesterol as well.
Our protocol is very similar to the one Kaiser Permanente used to achieve a blood pressure less than 140/90 in 750,000 patients. Their program is the most successful in hundreds of thousands of patients that I know of. The Kaiser Permanente protocol and our protocol are totally aligned with the guidelines from major cardiovascular organizations.
Our hypertension protocols do not include beta blockers because they do not provide as much protection and they have more side effects than our protocol drugs. There is “no evidence that beta-blocker based therapy, despite lowering blood pressure, reduced the risk of heart attacks or strokes.” We do not include beta blockers in our protocols for uncomplicated hypertension because they slow down the heart rate, create fatigue, limit our energy, and make the development of diabetes more likely. They don’t prevent major cardiovascular events in the treatment of high blood pressure, but they have multiple side effects. There are better choices.
The 2017 American College of Cardiology/American Heart Association and the 2018 European Society of Cardiology/European Society of Hypertension clinical practice guidelines recommend combination therapy from 4 drug classes including diuretics (hydrochlorothiazide), calcium channel blockers (amlodipine), ACE inhibitors (lisinopril), and angiotensin receptor blockers (losartan)… (and) recommend initiation of drug therapy with 2 medications in combination for most adults with hypertension (losartan/hydrochlorothiazide)…. Because prior studies strongly support the efficacy of spirononlactone or eplerenone to reduce BP in hypertension that is not controlled with losartan, hydrochlorothiazide, and amlodipine (resistant hypertension), the 2018 AHA Scientific Statement recommended these agents as the primary (fourth) add-on drug in the management of resistant hypertension. Adults with resistant hypertension have an increased risk for cardiovascular events and death compared with others that have high blood pressure that is more easily controlled. In view of the documented poor prognosis in uncontrolled resistant hypertension, increased attention to substitution of a thiazide-like fluid pill (chlorthalidone or indipamide) and addition of eplerenone or spironolactone should be of major critical importance in the management of resistant hypertension.
This is the approach that is most effective to control high blood pressure, but its benefits do not end there. Losartan, Amlodipine, eperenone, and spironolactone all have powerful antioxidant and anti-inflammatory effects. They protect every cell and organ in the body by activating the master metabolic switch AMPK. That is why they have more benefits to slow the progression of chronic kidney disease, congestive heart failure, and arterial disease compared with other medications that achieve the same blood pressure. The drugs in this protocol are truly precision medicines. This protocol is the most cost-effective approach to the high blood pressure problem. More on that in the next post. Controlling your blood pressure can be easy and inexpensive. Make sure that you are protected
Glad to see you added exercise and intermittent fasting to the picture. They do improve cardiovascular function detectable using Premier Heart’s Multifunction BioCybernetic Systems Information Technology. Yes! 👍
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