American College of Physicians: Internal Medicine — Doctors for Adults ®

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Hypertension guidelines lead to vigorous debate

From the April ACP Internist, copyright © 2014 by the American College of Physicians

Major guidelines on hypertension released last year appear to have raised perhaps as many questions as they answered. The American Society of Hypertension and the International Society of Hypertension released joint guidelines in December, followed closely by the guidelines from a panel convened by the Joint National Committee. However, the two had some differences, most notably regarding the ideal systolic pressure to aim for with treatment. With guidance conflicting, what is considered best practice when managing hypertensive patients? In our story, Charlotte Huff talks to experts in the field on all sides of the issue to examine the developing controversy and put it in perspective for clinicians.

Another story addresses issues specific to men’s health in middle age. Low testosterone, for example, has been covered extensively in the media lately, and use of androgen replacement therapy has increased dramatically in the past several decades, but the risks and benefits of such treatment are far from clear. Read our story to learn more about this issue, as well as erectile dysfunction, benign prostatic hyperplasia, and “manopause.”

Recent research has suggested that electronic health records (EHRs) may decrease the risk for malpractice claims, which is good news for practices that have adopted them. However, experts said, physicians should be aware that some EHR features could actually increase malpractice risk if not handled correctly. For example, an EHR’s copy-and-paste function may cause incorrect or outdated data to be carried forward indefinitely, and overriding a drug alert may lead to consequences down the line if the reason for the override was not documented. There are also questions about how the inability of EHR systems to communicate with one another could affect malpractice risk. Read more about this important aspect of practice management.

Another inside feature in this issue offers internists tips on how to help patients get the most out of referrals to physical rehab. Rehab medicine specialists advise that early referral is usually better, since patients’ functional status tends to decline over time. Physical rehab can also be of great benefit for neurological conditions and back pain, in the latter case even before any imaging is done. However, for some patients, such as those with dementia or those with chronic pain, rehab may not be a good fit, the experts said. Read our story to learn more.

Finally, ACP will hold its annual scientific meeting, Internal Medicine 2014, later this month in Orlando, Fla. Our staff will be on site as always to bring you the latest news. Check our blog and our Twitter feed, as well as our daily e-mail dispatches, to stay up to date. Let us know what you think of our coverage.

Sincerely,

Jennifer Kearney-Strouse

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