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Counseling patients on hypertension and the associated dementia risks

Kevin Hwang, MD, MPH, UTHealth Houston, Houston, TX, discusses the challenges of counseling patients with asymptomatic hypertension, highlighting that many individuals do not feel the direct impact of high blood pressure on their daily lives. Dr Hwang notes that educating patients on the link between controlling blood pressure and reducing the risk of dementia and myocardial infarction may motivate them to take their condition more seriously and make lifestyle changes or adhere to medication regimens. This interview took place on a virtual conference call with VJNeurology.

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Transcript

Hypertension for many, many individuals is asymptomatic. It’s a number. Some people may get a headache or may get blurry vision, you know, if it’s severely high, but a lot of people, they’re walking around with uncontrolled hypertension, but it doesn’t directly impact their daily lives at this time. They don’t necessarily feel that. So when we’re evaluating and treating patients in the ambulatory setting, a lot of times the challenge is, is counseling patients on the risk that their slightly high blood pressure holds...

Hypertension for many, many individuals is asymptomatic. It’s a number. Some people may get a headache or may get blurry vision, you know, if it’s severely high, but a lot of people, they’re walking around with uncontrolled hypertension, but it doesn’t directly impact their daily lives at this time. They don’t necessarily feel that. So when we’re evaluating and treating patients in the ambulatory setting, a lot of times the challenge is, is counseling patients on the risk that their slightly high blood pressure holds. And they would, they would ask us a very reasonable question, you know, well, what’s the big deal? I thought 138 was okay and things like that. So if we can we can show them that controlling blood pressure, especially like in the midlife age range, you know, forties, fifties, sixties, might actually reduce their risk for, well, will reduce their risk for dementia and myocardial infarction. That might convince some patients to say, yes, I’m going to really take it seriously now. I’m going to start the medication or I’ll work on my diet exercise or I’ll take my medication more consistently if they haven’t been taken consistently. So it’s just showing them another reason to pay attention to blood pressure because a lot of people really, that is one of their greatest fears to develop dementia. They may have known somebody, family members or friends that have gone through it and they don’t want to go through that themselves. If we can show them that link between blood pressure and cognitive decline, that might be really important. It would be a really important message for many patients to hear.

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