8 Initial Management of Hypertension About 10% of adults with hypertension have a specific and remediable cause of elevated BP.1-5.4 Genetic predisposition for hypertension cannot be altered, but many risk factors that contribute to elevated BP can be modified. Diet, overweight/obesity, physical activity and alcohol consumption can all be monitored and modified.1-6 Introduction Lifestyle modifications alone can help to reverse contributing factors, prevent future hypertension, including in those with elevated BP, and manage existing cases of hypertension.1-6 Introduction Screening for secondary causes of hypertension should be considered in all patients with hypertension, and in adults with resistant hypertension, if history and physical examination findings suggest a specific cause. Appropriate confirmatory testing should be completed before initiating treatment.1-5.4 Synopsis If a cause of secondary hypertension is identified and treated, these people can improve BP control and reduce CVD risk. A long list of common drugs and other substances can elevate BP, including: • Alcohol • Amphetamines • Angiogenesis inhibitors • Antidepressants • Atypical antipsychotics • Caffeine • Cocaine and multiple recreational drugs • Decongestants • Glucocorticoids • Immunosuppressive agents, such as cyclosporine and tacrolimus • Mineralocorticoids • NSAIDs • Oral contraceptives • Recombinant human erythropoietin • Sympathomimetic amines • Systemic corticosteroids • Tyrosine kinase inhibitors • Vascular endothelial growth factor (VEGF) inhibitors1-5.4.1, Table 14, 5-Table 2 The effects of these agents can be highly heterogeneous with most people showing little to no BP effect while others demonstrate severe BP elevations.5-Table 2
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