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Improving Practice Performance: Case Studies in Managing Hypertension

Please read through the following information and click the link at the bottom of the page.

Release Date: June 20, 2008
Expiration Date: June 20, 2009
Estimated Time to Complete Activity: 1 hour

Target Audience:
This activity has been developed for members of the primary care team including practicing physicians, physician assistants and nurse practitioners in the specialty areas of family, general, internal and emergency medicine and obstetrics and gynecology and other practitioners involved in the care of patients with hypertension.

Statement of Need:
Untreated, or undertreated, patients with hypertension are at significant risk for cardiovascular complications, stroke, renal failure, etc. The Joint National Committee on the Prevention, Detection, Evaluation and Treatment of High Blood Pressure - the JNC VII - has provided clear clinical guidelines to assist physicians in the proper management of hypertensive patients to prevent these complications. Physicians must have a clear and thorough knowledge of these treatment guidelines. Sixty-five percent of Americans 60 years and older have hypertension, but only a quarter of these have adequate blood pressure control. Those who are normotensive at age 55 have a 90% lifetime risk for developing hypertension. Hypertension with diabetes, heart failure, renal disease and many others significantly increase the risk of cardiovascular events. Treatment of high blood pressure with medication can reduce the risk of stroke by 31 to 45 percent, and myocardial infarction by 8 to 23 percent. Despite this benefit, control of hypertension in the ambulatory setting is suboptimal. Adherence to treatment regimens for high blood pressure is estimated to be between 50 and 70 percent.

Therefore, poor adherence to medical regimens is a major reason for poor control of hypertension. This poor control makes hypertension one of the most important confounding co-morbidities as a risk for cardiovascular disease. Causes for this may include poor patients' compliance, the cost of medications, medication side effects and patients' lifestyle and diet.

A multidisciplinary approach to treating hypertension to goal is the best way to control this disease and prevent cardiovascular complications. This CME activity will present effective strategies for improving patient compliance to the primary care team and patient advocates. Working together, we can make a difference!


Learning Objectives:
Upon completion of this activity, participants will be able to:

  • Aggressively screen for and manage hypertension, using evidence-based guidelines to help you and your patients set treatment goals
  • Target interventions (lifestyle changes and pharmacologic agents) to prevent disease progression and reduce morbidity and premature mortality
  • Recognize and remove important barriers to improving blood pressure control
  • Explore therapeutic combinations that can prevent disease progression and improve morbidity and mortality
  • Identify one change you can make to your practice that will support ongoing implementation of these lessons

Dr. David Feldman David Feldman, MD, PhD, FACC, FAHA
Associate Professor of Medicine; Director of Heart Failure and Cardiac Transplant, Division of Cardiology, Departments of Medicine and Physiology & Cell Biology, The Ohio State University, Columbus, OH

Program Development:
Michael O. Fleming, MD, FAAFP
Assistant Clinical Professor or Family Medicine and Comprehensive Care, LSU Health Science Center School of Medicine, Shreveport, LA; Assistant Clinical Professor of Family Medicine, Department of Family and Community Medicine, Tulane University Medical School, New Orleans, LA; Chief Medical Officer, Antidote Education Company, Dallas, TX

Susanna Guzman


Antidote Education Company is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. Antidote designates this educational activity for a maximum of 1.0 AMA PRA Category 1 Credit™. Physicians should only claim credit commensurate with the extent of their participation in the activity.

This activity has been reviewed and is acceptable for up to 2 Prescribed credits by the American Academy of Family Physicians. Of these credits, 1 conforms to the AAFP criteria for evidence-based CME clinical content. CME credit has been increased to reflect 2 for 1 credit for only the EB CME portion. AAFP accreditation begins 06/30/08. The term of approval is for one-year(s) from this date, with option for yearly renewal. When reporting AAFP credit, report total Prescribed and Elective credit for this activity. It is not necessary to label credit as evidence-based CME for reporting purposes.

The EB CME credit awarded for this activity was based on practice recommendations that were the most current with the strongest level of evidence available at the time this activity was approved. Since clinical research is ongoing, AAFP recommends that learners verify sources and review these and other recommendations prior to implementation into practice.

Method of Participation
Read the learning objectives and faculty disclosures.

  • Complete the pre-survey questions.
  • Study the educational activity.
  • Complete the post-test by recording the best answer to each question.
  • Complete the activity evaluation form.
A statement of credit will be issued automatically upon receipt of a completed activity evaluation form and a completed post-test with a score of 70% or better. There is no limit to the number of opportunities you will have to successfully complete the program.

There is no fee for participation in this activity.

Commercial Support:
This activity is supported by an educational grant from Novartis.

Antidote is committed to creating, developing, and operating high-quality, relevant, and practical continuing medical education activities that are in compliance with the ACCME's policies on commercial support and disclosure. Specifically, we are dedicated to ensuring that our events are planned and implemented free of the control of commercial interests and to identifying and resolving conflicts of interest of all persons in a position to control the content of an educational activity before the educational activity is delivered to our attendees. In addition, it is our standard practice to disclose all relevant financial relationships of our speakers in writing to our attendees before the beginning of an educational activity.

Individuals in a position to control the content of this CME activity reported the following relevant financial relationships with commercial interests:

David Feldman, MD, PhD, FAAC, FAHA
Presenting Faculty
Honorarium: GlaxoSmithKline, Johnson & Johnson, Novartis
Consultant: GlaxoSmithKline, Johnson & Johnson, Medtronic
Grants/Research: Medtronic

Michael Fleming, MD, FAAFP
Program Development
No relevant financial relationships to disclose.

Susanna Guzman
No relevant financial relationships to disclose.

Disclosure of Unlabeled Use:
The learner is advised that this CME activity may contain references to off-label or experimental or investigational uses of drugs or devices. The use of these agents outside currently approved labeling is considered experimental, and participants are advised to consult prescribing information for these products. This CME activity was planned and produced in accordance with ACCME Essential Areas and Policies.

The material presented at this course is being made available by Antidote Education Company for educational purposes only. This material is not intended to represent the only, nor necessarily best methods or procedures appropriate for the medical situations discussed, but rather is intended to present an approach, view, statement or opinion of the faculty which may be helpful to others who face similar situations.

Every effort has been made to assure the accuracy of the data presented at this course. Physicians may care to check specific details such as drug doses and contraindications in standard sources prior to clinical application.

Software Requirements:

Internet Explorer 5.5 or Firefox
*Adobe Acrobat Reader

*Required to view Printable PDF Version

Mac OS 10.2.8
*Adobe Acrobat Reader

*Required to view Printable PDF Version