Episode 47 - October 1, 2017 AFP: American Family Physician

AFP: American Family Physician Podcast

American Academy of Family Physicians

Medicine, Americanfamilyphysician, Afppodcast, Familymedicinepodcast, Afp, Clinicalpodcast, Aafp, Health & Fitness, Primarycarepodcast, Medicinepodcast, Aafppodcast

2.4 • 649 Ratings

🗓️ 2 October 2017

⏱️ 22 minutes

🔗️ Recording | iTunes | RSS

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Summary

Secondary hypertension (1:10), oral diabetes medications (6:50), testosterone therapy (9:50), food consumption (16:10), prolonged dual-antiplatelet therapy after myocardial infarction (17:50).

Transcript

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0:00.0	Welcome to the American Family Physician podcast for the October 1st, 2017 issue.
0:17.4	I'm Evan.
0:18.1	I'm Jake.
0:18.9	I'm Sue.
0:19.5	I'm Kelly.
0:20.6	We are residents and faculty, mostly residents,
0:23.3	at the University of Arizona College of Medicine Phoenix Family Medicine Residency Program.
0:28.7	Today on the podcast, we'll discuss secondary hypertension, an updated ACP recommendation for
0:35.2	oral diabetes medications, testosterone therapy, food consumption, and prolonged
0:41.2	dual anti-platelet therapy after MI.
0:44.2	The opinions expressed in the podcast are our own and do not represent the opinions
0:47.0	with the American Academy of Family Physicians, the Editor of American Family
0:49.8	Physician, or Banner Health.
0:51.2	Do not use this podcast for medical advice.
0:53.0	Instead, see your own family doctor for medical care. For those of you already going through Steve withdrawal, don't worry. He'll be back next episode.
1:17.2	Okay, first up, secondary hypertension, discovering the underlying cause from Dr. Charles, Triscott, and Dobbs from the University of Alberta.
1:27.2	Just when I was thinking that I finally have a good handle on hypertension, because I can now recite the JNC8 guidelines from heart while asleep, here's a friendly reminder that when we talk about hypertension, there are two types, primary and secondary.
1:40.7	It's like that metaphor. You don't want to miss the forest for the trees, but the reverse is true too. It's important to not forget about the redwood or the potentially reversible causes of hypertension. The tricky part is figuring out who to test for secondary causes and what tests to order, because otherwise it can be an expensive, low-yield process. And you might just miss that redwood. It's a forest analogy.
2:05.0	Right. So some clues that you might be dealing with secondary hypertension include onset before
2:10.3	30 years of age and definitely before puberty, and acute rise in previously stable blood pressure
2:16.2	readings. And lastly, severe or resistant
2:19.5	hypertension defined as a blood pressure of greater than 180 over 120 or hypertension that
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