Management of cardiovascular disorders and the pharmacist's role: Hypertension

Abstract

Hypertension is a major risk factor for cardiovascular diseases. The prevalence of hypertension is high globally, especially with a new definition by the American College of Cardiology and American Heart Association. Hypertension occurs as a result of either an increase in cardiac output or an increase in total peripheral resistance or both. Measurement of blood pressure should be performed using a validated device by trained healthcare professionals. Non-pharmacologic management of hypertension includes physical exercise, weight reduction, consuming a diet containing fresh fruits and vegetables, and limiting salt intake to less than 2 g/day. Clinical practice guidelines differ on when to initiate pharmacologic therapy and on blood pressure targets. The primary agents used for the management of hypertension include thiazide diuretics, angiotensin converting enzyme inhibitors, angiotensin receptor blockers, and calcium channel blockers. Pharmacist involvement in the management of hypertension has been shown to positively improve clinical outcomes. Pharmacists can play an important role in assessing and screening individuals, modifying drug therapy, monitoring response to therapy, and referral to physicians when appropriate. 2019 Elsevier Inc.