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Reposted by Jordy Cohen

Swapnil Hiremath 🍁🇨🇦 @hswapnil.medsky.social · 12d

There you go:

www.ahajournals.org/doi/10.1161/...

@ahascience.bsky.social statement from HT heavyweights

The Management of Elevated Blood Pressure in the Acute Care Setting: A Scientific Statement From the American Heart Association | Hypertension

Over the past 3 decades, a substantial body of high-quality evidence has guided the diagnosis and management of elevated blood pressure (BP) in the outpatient setting. In contrast, there is a lack of ...

www.ahajournals.org

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Reposted by Jordy Cohen

Penn Memory Center @pennmemorycenter.bsky.social · 22d

High blood pressure often shows no symptoms, but raises risk of stroke, heart disease, kidney damage, and dementia.
New American Heart Association guidelines: treat it early with diet & exercise.
“If you catch it early, you can gain many more years of healthy life,” says Penn’s Dr. Jordana Cohen.

The silent killer increases your risk of stroke and dementia. Here's how to control it

New recommendations for early treatment of hypertension to prevent strokes, heart attacks and dementia come as an experimental medication is shown to lower blood pressure in hard-to-treat patients.

www.npr.org

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Reposted by Jordy Cohen

Nephrology Journal Club @nephjc.bsky.social · 24d

And that’s a wrap!
In summary: screen carefully, stratify by risk, account for kidney health, and individualize therapy.
For nephrology, the wins are undeniable: albuminuria testing is mainstream, CKD visibility is heightened, and aldosterone is on the radar.

#NephJC

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Jordy Cohen @jordybc.bsky.social · 24d

Tried to keep up on my phone while being held hostage in my toddler’s room 😳

Great chat!

#nephjc

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Reposted by Jordy Cohen

Nephrology Journal Club @nephjc.bsky.social · 24d

T4l
1️⃣2️⃣No aggressive IV treatment for severe asymptomatic HTN - avoid acute inpatient lowering if no target-organ damage (COR III: Harm, LOE C-LD).
📝Treat the patient (situation) not the number for acute HTN during hospitalization. I have trouble convincing nocturnists of this. #NephJC

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Jordy Cohen @jordybc.bsky.social · 24d

www.nejm.org/doi/full/10....

There’s some trial data on prevention of albuminuria

#nephjc

Preventing Microalbuminuria in Type 2 Diabetes | NEJM

The multicenter double-blind, randomized Bergamo Nephrologic Diabetes Complications Trial (BENEDICT) was designed to assess whether angiotensin-converting–enzyme inhibitors and non-dihydropyridine ...

www.nejm.org

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Jordy Cohen @jordybc.bsky.social · 24d

#nephjc

a woman is holding a red megaphone in front of her mouth

Alt: a woman is holding a red megaphone in front of her mouth

media.tenor.com

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Reposted by Jordy Cohen

Nephrology Journal Club @nephjc.bsky.social · 24d

T4j
🔟CKD with albuminuria - ACEi/ARB strongly recommended to delay CKD progression and reduce CVD (COR I, LOE A).
📝Still only 35-50% of eligible patients get them. How do we move the needle on this? #NephJC

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Jordy Cohen @jordybc.bsky.social · 24d

Yes! Slide care of Paul Whelton at this year’s #Hypertension25

#nephjc

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Reposted by Jordy Cohen

Nephrology Journal Club @nephjc.bsky.social · 24d

T4i
9️⃣Cognitive protection🧠 - treat to SBP <130 to prevent mild cognitive impairment/dementia (COR I, LOE B-R).
📝Do you think BP control has a significant role in dementia? #NephJC

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Jordy Cohen @jordybc.bsky.social · 24d

Even when we say we will use MRAs earlier, we don’t! We showed this. Screening is associated with WAY more MRA use (probably in part because those who think to screen are more likely to treat based on best evidence)

pmc.ncbi.nlm.nih.gov/articles/PMC...

#nephjc

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Reposted by Jordy Cohen

Dr Pallavi Prasad, MD, DNB ( Nephrology) @drpallaviprasad.bsky.social · 24d

Proposed mechanism in Nature #NephJC
www.nature.com/articles/s41...

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Jordy Cohen @jordybc.bsky.social · 24d

That was the goal with the encouragement without saying it’s absolutely required. It’s not feasible or appropriate in everyone/should be tailored to the individual.

Overall, it’s to swing the pendulum to aim lower when possible

#nephjc

a black background with a gold circle and a la logo

Alt: Pendulum

media.tenor.com

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Jordy Cohen @jordybc.bsky.social · 24d

Captures similar people

From the AHA scientific statement on PREVENT:

www.ahajournals.org/doi/10.1161/...

#nephjc

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Reposted by Jordy Cohen

Cristina Popa @nephroseeker.medsky.social · 24d

I would dare to say many people: if too young, if single pill combo is not enough to control BP. PA is more common than we are used to think. Usually, for us nephrologists is even harder to screen when pts are already on 4-5meds #nephjc

www.nephjc.com/news/primary...

Undercover Aldosterone — NephJC

This week, we will discuss the origins of primary hyperaldosteronism in normotensive patients. Could this undetected anomaly be the cause of idiopathic hypertension and CKD?

www.nephjc.com

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Jordy Cohen @jordybc.bsky.social · 24d

AHA/ACC came close! Anyone with BP >140/90

#nephjc

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Jordy Cohen @jordybc.bsky.social · 24d

Annually #nephjc

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Jordy Cohen @jordybc.bsky.social · 24d

#nephjc

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Jordy Cohen @jordybc.bsky.social · 24d

Same with the AHA/ACC guideline (well, close — anyone w/BP >140/90)!!
👇

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Jordy Cohen @jordybc.bsky.social · 24d

The guidelines point out literature that home BP seems prognostically similar to ABPM and better for repeatability/longitudinal monitoring. We still use ABPM a lot, but for situations where we need more detailed data (BP lability, new target organ damage, unclear if home BPs are accurate)

#nephjc

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Jordy Cohen @jordybc.bsky.social · 24d

This is what happens when there are 3 nephrologists on the writing committee 🤓

#nephjc

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Jordy Cohen @jordybc.bsky.social · 24d

Calling out the shift to automated devices!

🩺Aneroid devices are easily miscalibrated and require frequent recalibration (plus perfect hearing!) — not the best option

🤖Automated devices aren’t prone to miscalibration but need to be correctly validated — check out www.validatebp.org

#nephjc

Home | Validate BP

The VDL is a free resource to help patients and physicians find blood pressure devices that have been validated for clinical accuracy. Supported by the AMA.

www.validatebp.org

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Reposted by Jordy Cohen

Nephrology Journal Club @nephjc.bsky.social · 24d

T0b
Is HTN still a problem worth our attention? Haven’t we conquered this ‘Silent Killer’ yet? Answers: YES it’s a problem, NO we’ve not conquered it.
#NephJC

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Reposted by Jordy Cohen

Nephrology Journal Club @nephjc.bsky.social · 24d

T0c
Check out these sobering stats:
➡️More than 1.3 billion with HTN globally, 1.2 billion without control
➡️46.7 % HTN prevalence in the US from 2017 to 2020
➡️Leading cause of death and disability worldwide

#NephJC

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Jordy Cohen @jordybc.bsky.social · 24d

Jordy Cohen from University of Pennsylvania here for what’s certain to be an exciting #nephjc!

I’m perhaps biased as a member of the writing committee of the 2025 AHA/ACC BP guideline…

No other COIs

a stuffed animal wearing a hockey helmet and a beard

Alt: Gritty giving two peace signs

media.tenor.com

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