1 Start 2 Complete InstructionsPlease complete the Module 4: Hypertension Follow-up Survey and tell us what you learned from this module. Your response is important, and will be used to demonstrate the value of this educational program and to guide development of future CME activities. Thank you for your participation. Please provide your email so we can contact you with promotional information including drawings and prizes for completing this survey. This field is optional. A 45-year-old woman presents for evaluation of newly diagnosed hypertension. She had confirmation of a diagnosis of hypertension via a 24-hour ambulatory blood pressure monitor (141/ 87 mmHg average 24-hour blood pressure). She has no other medical diagnoses. She has a family history of diabetes mellitus and primary hypertension. Secondary evaluation for hypertension included a renal artery ultrasound, urine testing for pheochromocytoma / paraganglioma, and a TSH. These were all unremarkable. Additional testing included serum aldosterone / renin testing. Her direct renin concentration was less than the lower limit of the assay (in this case < 2.1 pg/mL) and aldosterone was 11.5 ng/dL. Which of the following is the next best step? Initiate treatment with monotherapy with lisinopril Refer for testing for possible primary aldosteronism including 24-hour urine sodium collection in setting of high sodium diet Make a diagnosis of primary aldosteronism and initiate treatment with spironolactone Initiate lifestyle changes including low sodium diet and have scheduled for follow-up in 3 months Which of the following statements is TRUE about ambulatory blood pressure monitoring? BP measured at home while seated, resting quietly w/back supported and feet on the floor Multiple readings taken with an automatic BP machine by the patient Wearable device that records BP over time and that measures BP during routine activities Inexpensive and widely available Which of the following has the largest evidence based data and is the most appropriate goal BP in someone who has diabetic kidney disease and 200 mg/g albuminuria with an eGFR=50 ml/min/1.73m2? <140/90 mmHg <120/80 mmHg <130/80 mmHg <135/85 mmHg <125/75 mmHg A 58-year-old African American female patient with hypertension and type 2 diabetes (T2D) presents to your office for follow-up and has a BP of 180/100 mmHg. She is currently not on any medication for hypertension and mentions that she has tried to control it in the past with better diet and exercise. Which of the following drugs is the best initial regimen to address her elevated BP? ACE inhibitor Thiazide-type diuretic or calcium channel blocker ARB Loop diuretic Which of the following agents should be used as a fourth line therapy in truly resistant hypertension? Alpha blocker Beta Blocker A steroidal mineralocorticoid receptor blocker A non-steroidal mineralocorticoid receptor blocker Hydralazine How many patient encounters have you had in the last 90 days? * <200 200 400 600 800 1000 1200 >1200 As a result of this educational activity, did you make any changes to your clinical practice? * Yes No What specific changes did you make to your practice as a result of information received in this activity? (Select all that apply) * Consider and recommend out-of-office BP measurements to help screen and diagnose hypertension Assess patient adherence to antihypertensive therapy Initiate and intensive antihypertensive therapy as recommended in the guidelines to treat uncontrolled and resistant hypertension Recommend lifestyle modifications in addition to pharmacotherapy for BP control What additional improvements have you made in your clinical practice after participating in this activity? * What barriers are currently preventing you from making these changes? (select all that apply) * Formulary restrictions Insurance/financial issues Time constraints Lack of interprofessional team support System constraints Treatment related adverse events Patient adherence/compliance None Were the changes that you made in clinical practice beneficial to patient care?* * Yes No Has this course improved the comprehensive treatment of your patients with cardiometabolic disease or cardiometabolic risk? * Yes No Please explain your above answer. * Leave this field blank