Hypertension

I.        Program Content

1. Trainees must acquire knowledge and understanding of the following areas during the course of their training:

1. Epidemiology of hypertension.

2. Pathogenesis and natural history of primary hypertension.

3. Evaluation of the hypertensive patient.

4. Nonpharmacologic therapies of hypertension.

5. Pharmacology and clinical use of antihypertensive agents.

6. Hypertension in renal parenchymal disease during chronic dialysis and after renal transplantation.

7. Renovascular hypertension: pathogenesis, causes, clinical features, screening and diagnostic tests, and management.

8. Oral contraceptive-induced hypertension.

9. Pheochromocytoma: pathophysiology, clinical features, diagnosis, and management.

10. Primary aldosteronism: pathophysiology, clinical features, diagnosis, and management.

11. Other forms of secondary hypertension:  Cushing’s syndrome: congenital adrenal hyperplasia; coarctation of the aorta; thyroid disease; hyperparathyroidism; acromegaly; sleep apnea; and drugs.

12. Hypertensive emergencies and urgencies.

II.      Patient Care Experience

1. Trainees should be familiar with and have experience in the direct diagnosis and management of the following areas in both the outpatient and inpatient setting:

1. Trainees must be able to assess the severity of hypertension and end-organ damage.  They should be familiar with the role of ambulatory blood pressure monitoring in the evaluation of the hypertensive patient.

2. Trainees must be able to define goals of treatment, be familiar with the non-pharmacologic modalities as well as the use and side-effects of antihypertensive agents, and be able to make appropriate therapeutic choices in the context of co-morbid conditions.

3. Trainees must be familiar with the management of hypertension in renal parenchymal disease during chronic dialysis, and after renal transplantation.

4. Trainees must be able to identify symptoms and signs suggestive of secondary causes of hypertension, and be familiar with the various screening and diagnostic tests as well as the management of these disorders.

5. Trainees must become familiar with the management of the various hypertensive emergencies and urgencies.