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Hypertension: Evidence-Based Treatment and Clinical Challenges

Course Description | Faculty | Accreditation | General Information

Course Description

Hypertension accounts for more primary care office visits than any other chronic medical condition. This course provides an evidence-based approach to the diagnosis and treatment of hypertension. Primary care clinicians will find this course invaluable in the care of their patients with this common and morbid condition. In this course, we provide an approach to the initial management of patients with hypertension. In addition, using a case-based interactive model, we will explore challenges and controversies in hypertension. These will include resistant hypertension, secondary hypertension, white coat hypertension, and the diabetic patient. We provide advice on drug selection and will help participants navigate the complex and extensive recent literature to learn practical strategies for optimal patient care.

The course contains 6 separate case scenarios in order to explore these topics and learning objectives. At the completion of this course, participants will be able to competently manage patients with hypertension in the primary care setting. The course makes use of photos, figures, and tables to enhance the learning experience. We provide details of recent seminal randomized controlled trials of the treatment of hypertension to support our recommendations and advice.

Original Release: 3/28/2006
Most Recent Update: 9/10/2013
Termination Date: 9/10/2016

NUMBER OF CREDIT HOURS: The Harvard Medical School designates this enduring material for a maximum of 3 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

This course should take approximately 3 hours to complete.

COST: COST: $75.00

OVERALL LEARNING OBJECTIVES:

  1. Learn an evidence-based approach to the management of patients with hypertension
  2. Understand that not all medications that lower blood pressure equally reduce cardiovascular risk
  3. Demonstrate knowledge of unique treatment issues in specific categories of patients including the elderly, African-Americans, and diabetic patients

CLINICAL LEARNING OBJECTIVES:

  1. Learn the key points and treatment algorithm as proposed by JNC-7
  2. Understand the initial approach and non-pharmacologic management of patients with hypertension
  3. Demonstrate knowledge of initial drug monotherapy of hypertension
  4. Learn how to evaluate and treat resistant hypertension
  5. Understand the evaluation of suspected secondary hypertension
  6. Appreciate the unique issues in the treatment of hypertension in diabetic patients
  7. Recognize the significance and diagnostic issues of white coat hypertension
  8. Distinguish hypertensive emergencies from hypertensive urgencies and understand the principles of treatment of each

METHOD OF PARTICIPATION:

Registrants participate in the learning process by answering interactive multiple choice questions that are dispersed throughout the case presentation. You must answer a question correctly in order to continue through the course. If you answer a question incorrectly, you will be prompted to try again.

In order to earn credit, physicians must complete the entire educational activity before the termination date (see above). Non-physicians may register for the course but are not eligible for AMA PRA Category 1 Credits™. Instead, non-physicians will earn a certificate of participation after successfully completing the course before its termination date.

COMBINATION OF MEDIA USED:

This internet enduring material is a case-based, interactive presentation comprised mainly of text, interactive questions, and images. A variety of media, including video clips, audio clips, and Flash animation, may be presented. Links to any necessary plugins are provided when necessary, but no plugins are required for general use of the CME website, and you may skip the multimedia presentation(s) within the course if you choose.

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Faculty
JOHN D. GOODSON, MD
Course Co-Director
John Goodson is a lifelong clinician educator with 30 years experience as a course planner, lecturer, workshop leader, and writer. His interests in health care began as an America Social History major at Columbia University where his senior thesis described the origins of home health care in New York City during the Progressive Era. As a medical student at Stanford, Dr Goodson organized and taught course on consumer participation in health care reform.

Dr Goodson trained at the Massachusetts General Hospital (MGH) in primary care internal medicine and joined the Harvard Medical School Faculty and the staff of the MGH on completion of his residency. Dr Goodson in currently an Associate Professor of Medicine at Harvard and a Physician at the MGH.

Dr Goodson’s academic interests include the organization and content of medical residency education with at focus on the ambulatory training experience. He was the curriculum director of the MGH ambulatory training for 8 years and the evaluation director for over 20 years. He has written both about the implementation of training in outpatient practice and about common outpatient medical conditions such as male and female urologic disorders. Dr. Goodson participated in the case-based innovations of the Harvard Medical School New Pathway curriculum.

Dr Goodson’s involvement in continuing medical education began in his early career. He has nearly 30 years experience in one of Harvard’s most successful courses for primary care physicians and his presentations are among the best of a very exclusive faculty.

DISCLOSURE:
Reported no relevant financial relationships with commercial entities



GERALD W. SMETANA, MD
Course Co-Director
Gerald W. Smetana, M.D. is a member of the Division of General Medicine and Primary Care at Beth Israel Deaconess Medical Center and an Associate Professor of Medicine at Harvard Medical School. He received his medical degree from the University of California, San Francisco and completed his medical residency at Beth Israel Hospital. He is a teacher clinician with an active primary care internal medicine practice who has devoted much of his 20 year career in medicine to teaching medical students, residents, and practicing physicians. Dr. Smetana held the position of Associate Firm Chief at Beth Israel Medical Center for 10 years during which time he received the Herrman Blumgart award for outstanding contribution to the education and professional development of the medical housestaff. He was also the recipient of the 2004 National Award for Scholarship in Medical Education from the Society of General Internal Medicine. He has been selected by his peers as one of the Best Doctors in America in a national survey. Dr. Smetana's academic interests include hypertension, perioperative medical evaluation, and headache. He is the lead author of numerous systematic reviews for the peer reviewed literature and text chapters on these topics. He chairs a committee at the American College of Physicians to develop a position statement on preoperative pulmonary evaluation. He is also chair of a Society of General Internal Medicine committee that is preparing a series of systematic reviews on the outcomes of medical care provided by generalists versus specialists.

DISCLOSURE:
Reported no relevant financial relationships with commercial entities.



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Reviewers
GRACE HUANG, MD
Reviewer
Grace Huang, MD, is the Director of the Office of Educational Technology at the Carl J. Shapiro Institute for Education and Research, a joint venture between HMS and Beth Israel Deaconess Medical Center (BIDMC) in Boston. She also works as a hospitalist at BIDMC. She has spent a number of years designing web-based modules on clinical skills, including computer-based case simulations (“virtual patients”), physical diagnosis tutorials, interactive pathophysiology diagrams, and procedure-based instruction. She serves as a consultant to the Association of American Medical Colleges in their initiative to promote scholarship and sharing of educational materials through MedEdPORTAL. Her clinical research interest is in the impact of a formal hospital-based procedure service on complication rates among internal medicine residents.

DISCLOSURE:
Dr. Huang's spouse works at Pfizer, Inc., and she holds stock options and shares in the same company.



ROBERT H. SHMERLING, MD
Reviewer
Robert H. Shmerling, M.D., is associate physician at Beth Israel Deaconess Medical Center and Associate Professor in Medicine at Harvard Medical School. For the last 20 years, he has been an active clinician and teacher at Beth Israel Deaconess Medical Center where he serves as the Robinson Firm Chief. He is also a practicing rheumatologist and teacher in the Rheumatology Fellowship program.

DISCLOSURE:
Reported no relevant financial relationships with commercial entities



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Course Planners
SANJIV CHOPRA, MD
Planner
Dr. Sanjiv Chopra is Professor of Medicine at Harvard Medical School. He is also the the James Tullis Firm Chief in the Department of Medicine and a Senior Consultant in Hepatology at the Beth Israel Deaconess Medical Center, Boston. He served as Faculty Dean for Continuing Education at HMS for 12 years. Dr. Chopra has more than 150 publications and seven books to his credit. Dr. Chopra is Editor-in-Chief of the Hepatology Section of UpToDate, the most widely used electronic textbook in the world subscribed to by more than 850,000 physicians in 149 countries. He is also the recipient of numerous awards and accolades. For a complete bio, click here.

DISCLOSURE:
Reported no relevant financial relationships with commercial entities



ANDI LONG, EdM
Planner
Andi Long directs the Department of Continuing Education’s Distance Learning group, which offers a variety of online continuing medical education programs to health care professionals around the world. Andi develops strategies for new pilot programs and systematically rolls out new distance learning initiatives and has a leadership role in IT planning and other online processes for HMS DCE. She oversees the day-to-day operations of each distance learning activity and ensures ACCME compliance across all enduring programs. She has had the privilege of working with hundreds of Harvard Medical School Faculty members to develop high-quality, engaging online programs that physicians in more than 170 countries have taken part in. Andi earned her Ed.M. in Technology, Innovation, and Education from Harvard Graduate School of Education and graduated from Bridgewater State College with a degree in English. Her professional interests focus on teaching and learning with new technologies and online course development.

DISCLOSURE:
Reported no relevant financial relationships with commercial entities



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Accreditation

NUMBER OF CREDITS: 3 

The Harvard Medical School is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

The Harvard Medical School designates this enduring material for a maximum of 3 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

This course should take approximately 3 hours to complete.

Within 2 weeks of completing the course, you will receive your certificate via email.

Click the image to view a sample of the certificate


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General Information

HARDWARE/SOFTWARE REQUIREMENTS

Computers
Any computer running Windows, Mac OS, or Unix machines are supported.


Internet Connection
Your computer should be configured to access the Internet. A high speed internet connection may be required to view some of the large multimedia files.

Browsers
Firefox or Internet Explorer 5.5 or higher are recommended. JavaScript and cookies must be enabled.

Plugins
Some of the multimedia resources in this course require Apple Quicktime, RealMedia, or a Flash player. You will be prompted to download the appropriate plugin when necessary. No plugins are required for general use of the CME website, and you may skip the multimedia presentation(s) within the course if you choose.


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