IMPORTANT POINTS: How to start Step 1 of Treatment Treatment: Patient age < 55 start ACE inhibitor Patient Age >55 or Afrocaribean Origin Start Calcium Channel Blocker Step 2 of Treatment If not controlled with the above drug Then give both CCB and ACEi together Step 3 If still not controlled Add thiazide Diuretic to the above acei and CCB combination Chlorthalidone 12.5 to 25mg once daily can be added or Indapamide 1.5mg modified release once daily or 2.5mg once daily Can be used At each step always try to find the cause why is patient not improving causes like non adherence and life style changes.
Dear Dr. Fazal, Thank you for sharing your knowledge. Your videos are concise and easy to follow. I am a 64-year-old RN that has returned to school to realize the dream of becoming a Family Nurse Practitioner. I know I’m old but I am healthy and have many good years ahead of me. I supported my husband’s career and put my daughter through a PharmD program, now it’s my turn. Again, thank you and I look forward to more of your videos. Many blessings!
Very informative, I’m also going to use this opportunity to recommend Dr IGUDIA on RUclips who cured my type 2 Diabetes with his natural herbs medication
MAM what you have said is trully an inspiration for me to become an awesome doctor !!!! i was not using my medical school time well and didn't use my entrance exam preparation time well and im forced to earn for myself now by father, as im working in my wards sir's videos and one year internship from a govt. college are helpful for me to treat patients but there was always this regret that , why havent i started learning like this in med school and i would always be in an anxious state of thinking that "is it too late to learn all this", im 25 btw. but you at the age of 64 gave me an inspiration for me.
You're the best Doc. Surely your videos are worth dollars💵. But since you have a helping heart you've chosen to help us than doing a business. You're a true hero❤️❤️ Trust me only this video will save so many lives. I respect you Doc. May Allah bless you 🙏
Ameen.. So kind of you Minhaj Sahal. I am humbled. My videos are and will always be free for everyone. Comments like these always boost up my morale to post more videos for people. With best wishes Dr. Waqas Fazal 😊
sir we are waiting for the history taking techniques series , good history presentation and sir kindly can you mention the dosage as it will help us to grasp much more..keep on coming such amazing lectures
Sir sometimes I have seen that only diastolic pressure is elevated, then what type of hypertensive drug I can recommend to my patient, Your channel is really very much fruitful for us because every time it is not possible to go through the books, your video in short clarify all the issues , thank you for your valuable information sir
Thank you doctor, kindly manage this patient who defaulted for 2 yrs,she has pressure of 241mmhg/112mmhg, walking normally,but has bit of headache and dizziness.thanx
All are Very nice videos We need a one lecture series of more details and that should be more than one hour.. It should be more practical and self assessment
@@MedNerdDrWaqasFazal @5:56 I meant to ask vis a vis Starting Medications of HTN since you have not mentioned ARBs. Aren’t ARBs considered superior to ACE Inhibitors? Any particular reason ARBs are not mentioned.
Sir plz murmurs per detail vadio bnaw plzzzzzzzzz sir g....u best explaining so plz detail vedios bnaw js trah ECG per bnaya hein.... Mechanism Cause Actual voice and so on.....
Hello doctor, my mom’s BP is usually above 140/90 even after being given Telmisartan+Hydrochlorothiadize 12.5 mg (half tablet) every day. She is unable to walk or do exercise due to bowed knees and recently came out of hospital after being treated for pneumonia + kidney damage in ICU for 12 days Kindly suggest best treatment for her BP management
Hi Dr Waqas, I hope you are doing well. In regarding of deciding to starting patient on antihypertensive medication Should the patient be started on monotherapy or dual therapy? And for example patient blood pressure been noted to be 170/100 And last visit was 159/87
My BF is 31. Has htn. Good shape eats healthy. He went to the ER three times during a weekend bp 183/114. They said oh yeah African Americans tend to get hypertension, here’s 5mg of amlodipine. That’ll do it… no prescription nothing. He was dizzy, severe headache the whole nine that was on Saturday morning, Saturday afternoon back in the ER gave 5 mg of amlodipine, this time gave 6 pills to take home. Sunday afternoon back in the ER only a few hours after taking amlodipine. I asked if they can give him an ace inhibitor. The doc said it takes a week or so for the amlodipine to work but stop taking your bp for a few days I think you’re just getting working up. I hate it here!
Sir, my mother is taking atenelol 50mg since 5 years and present she is doing fine. She was given beta blockers because she complained of palpitations. Now is there necessity to change into other first line drugs or continue medication for rest of her life?
Hi Dr. Waqas I have 48 years old patient who's blood pressure 148/87 and on next visit 147/82 He is morbidly Obese having symptoms of fatigue weight gain (BMI is 50) mood changes and infertility I ordered basic labs plus TSH His TSH was 7.61 with normal free t 3 and ft4 plus negative antiTPO antibodies, his ASCVD risk is 5% T.cholesterol 233 LDL 170 HDL 46 and TG 81 Serum creatinine is 1.1 HBA1C is 6.2 FBS is 94 I started him on valsartan 80 mg Rosuvastatin 10 mg And metformin 750xr Plus advise for lifestyle modifications I postponed the treatment of subclinical hypothyroidism till after 3 months. What are you suggestions please respond
IMPORTANT POINTS:
How to start Step 1 of Treatment Treatment: Patient age < 55 start ACE inhibitor
Patient Age >55 or Afrocaribean Origin Start Calcium Channel Blocker
Step 2 of Treatment
If not controlled with the above drug
Then give both CCB and ACEi together
Step 3
If still not controlled
Add thiazide Diuretic to the above acei and CCB combination
Chlorthalidone 12.5 to 25mg once daily can be added or Indapamide 1.5mg modified release once daily or 2.5mg once daily Can be used
At each step always try to find the cause why is patient not improving causes like non adherence and life style changes.
How long to wait before adding another drug?
❤❤
Dear Dr. Fazal, Thank you for sharing your knowledge. Your videos are concise and easy to follow. I am a 64-year-old RN that has returned to school to realize the dream of becoming a Family Nurse Practitioner. I know I’m old but I am healthy and have many good years ahead of me. I supported my husband’s career and put my daughter through a PharmD program, now it’s my turn. Again, thank you and I look forward to more of your videos. Many blessings!
Thank you Sandra... I am very glad to hear that. Wish you success in your efforts. Stay tuned for more videos.
Very informative, I’m also going to use this opportunity to recommend Dr IGUDIA on RUclips who cured my type 2 Diabetes with his natural herbs medication
MAM what you have said is trully an inspiration for me to become an awesome doctor !!!! i was not using my medical school time well and didn't use my entrance exam preparation time well and im forced to earn for myself now by father, as im working in my wards sir's videos and one year internship from a govt. college are helpful for me to treat patients but there was always this regret that , why havent i started learning like this in med school and i would always be in an anxious state of thinking that "is it too late to learn all this", im 25 btw. but you at the age of 64 gave me an inspiration for me.
👏🏽👏🏽👏🏽
You're the best Doc. Surely your videos are worth dollars💵. But since you have a helping heart you've chosen to help us than doing a business. You're a true hero❤️❤️
Trust me only this video will save so many lives.
I respect you Doc. May Allah bless you 🙏
Ameen.. So kind of you Minhaj Sahal. I am humbled. My videos are and will always be free for everyone. Comments like these always boost up my morale to post more videos for people.
With best wishes
Dr. Waqas Fazal 😊
Can't thank you enough for what u r doing for medical ug students like me ❤️
I am a PA student going to clinical and this breakdown on how to treat the difference stages is so easy to understand! Thank you so much!!
U are doing a great job sir.
Spreading knowledge and helping clinicians in better management of patients on daily basis
You are very kind to say that. Keep supporting 😊
Thanku so much Dr.Waqas for eloborating to dustoff out brains
I must say this is the best channel I have ever visited so far
Eesa Ismail, I am glad to hear that. 😊
MashAllah Allah swt has blessed you with knowledge.Please keep making videos ❤
So kind of you. 😊
Dr.Your lectures are very clear ,concise and very helpful,thank you in advance!!!
sir we are waiting for the history taking techniques series , good history presentation and sir kindly can you mention the dosage as it will help us to grasp much more..keep on coming such amazing lectures
Thank you Hamad. I am sorry for being late on that. I am having a very busy schedule these days. I am trying to post more videos.
@@MedNerdDrWaqasFazal Please do that sir, it will help us a lot.
Wow what a great lecture On HTN, watched you Vedio and realized this is what i was searching for so many times.
Thank you sir keep making Vedios
Thanks for wonderful lectures about HTN
Thank u so much sir bahut hi achhi trah samjhaya ye topic 😊😊❤
Impressive👍 Allah bless u....
Keep it up
...
Gud job Dr.
Amazing videos sir
Thank you so much for all the time you have devoted to these lectures
Thank you for your kind words. 😊
How lucky I am to have come across this video, thanks Doc
Sir sometimes I have seen that only diastolic pressure is elevated, then what type of hypertensive drug I can recommend to my patient,
Your channel is really very much fruitful for us because every time it is not possible to go through the books, your video in short clarify all the issues
, thank you for your valuable information sir
Hats off doc.... Beautifully explained.. Helpful for family medicine practitioner
Sir my age is 50 year's I have behind sternum now I am what to do.
Please give me reply thanks.
finally you uploaded some content..keep it up bro
Your explanation is amazing sir thanks for this amazing work
Sir, very valuable information.
Thank you so much.
Sir, you didn't mention about ARBs...how and when they should be preferred? In which conditions?
Exellent Exellent lectures , Sir. More power to you❤
Sir , whats the effect of age factor on BP values and their management methods ?
Excellent most concise easily retainable videos❤
U are so talented💗....love from Pakistan🌼🌼
Thank you Zulekha for such kind words. 😊
Sir you shouldn't stop making such wonderful videos.
I will not, till people like you keep supporting me. 😊
Please keep doing this!!! Prayers with u sir..
Very nice talk on Hypertension 👍
Great sir..MASHALLAH 🥰🥰
Excellent explainer mashallah.
Nice presentation obviously!
Your all presentations are precious.
Please more videos about important all diseases of all subbranch of Medicine.
We need more details about each medicine,say metoprolol ,max dose, when to give morn ev etc
Nice video sir. Very useful for me. Thank you sir 🙏
Sir Excellent,on cardiac lecture,pul.Embolism and pul.hypertention need to give us.
Thank you Dr. Kumar. I already have made videos on many topics that you just mentioned you can check them out on my channel. 😊
Thank you doctor, kindly manage this patient who defaulted for 2 yrs,she has pressure of 241mmhg/112mmhg, walking normally,but has bit of headache and dizziness.thanx
Sir please make a video on step-by-step management of hypothyroidism/hyperthyroidism
Sure, Rafiqur Rahman. I will. 😊
sir thank you so much if you can give gyne lectures of pre eclampsia GDM and some more conditions would highly appreciate ❤❤
جزاك الله خيرا
Good review and up to date information
Thank you Dr. Kamal! 😊
Great information ❤
Love you sir ,hatts off 💯
Excellent job
Simple and nice presentation sir
All are Very nice videos
We need a one lecture series of more details and that should be more than one hour..
It should be more practical and self assessment
Sure Dr. Shaukat Ali. I will post a detailed video. 😊
Thanks sir your valuable information
Sir kindly 1 lecture on. Opd based treatment on lipid management. And. Antibiotics in different condition
Sir plz upload treatment guidlines for isolated systolic and diastolic hypertension
thanks for fruitful information
Good , simple and useful
Sir please make a video about AMS(acute mountain sickness) and briefing the HAPE and HACE and how to treat it?
Sure MD hasan Khan... Keep supporting 😊
Great 👌
wonderful video
Good👍👍👍
Thanks so much Dr I have understood very well
Best of the best! Thsnk you so much
You are the best doc thank you
When to use sympatholytics like atenolol 2.5mg for treatment??
How to know doses given and which drug is more preferred in their group
Please make a detailed video
Great explaination sir...!
Well explained🙏
Which do you think is better?
ACEi or ARBs ?
Why Calcium Channel Blockers are preffered over ACEi/ ARB in ELDERLY ?
Thank you so much. Very very helpful.
Strong work, Doctor!
But sir ace inh not easily available in market . Mostly found is ARB. Can we give arb in co morbid pt
Thanks you so much sir )) keep making videos like this
Thank you Prabhanshu Mudgal. Stay tuned for more videos on hypertension series. 😊
Could you please explain the use of lasix in hypertensive emergency and urgency ? And is this right practice to use in all emergencies?
Thank you. Your videos are great.
Thank you for the enlightening tutorial. Why have you left out the ARB's ?
Thank you Irfand4. I have talked about ARB'S in my video on "Drugs for hypertension"
@@MedNerdDrWaqasFazal @5:56 I meant to ask vis a vis Starting Medications of HTN since you have not mentioned ARBs. Aren’t ARBs considered superior to ACE Inhibitors? Any particular reason ARBs are not mentioned.
ARB'S are preferred in cases where patients get chronic dry cough due to ACEi use. In practice, you are very right, ARB'S are preferred drugs.
@@MedNerdDrWaqasFazal thank you for your prompt and enlightening reply Dr Waqas. Best wishes.
@@MedNerdDrWaqasFazal you are an amazing doctor. You really care about what people are asking here. Thank you for all your videos and work.
Sir plz murmurs per detail vadio bnaw plzzzzzzzzz sir g....u best explaining so plz detail vedios bnaw js trah ECG per bnaya hein....
Mechanism
Cause
Actual voice and so on.....
Nicely explained...
Sir plz made a video on throxine dosage dosage according to tsh
hello can you make a video about neurotoxin management or drug overdose.Your videos are extremely helpful!
Optimal treatment for a ESRD patient with HTN??
Great teacher
Thank you Bilal Mushtaq for your kind words. 😊
Sr.. the discussion is great . But I needs to know what is your sources?!.
Thank u so much sir 🙏🏻
Great video
Nice sir
Very nice sir.Thanks
Thanks Manu Sharma 😊
This is soo much helpful ❤️
Thank you Aquib Patel. 😊
@@MedNerdDrWaqasFazal can u make more such videos on different diseases??
Sir please tell me management of epistaxis due to malignent hypertension
Thank you so much dr
Excellent
Thank you Doc!!
Sir in which patient we can use ARBs
What to do if there is contradiction to ccb and not controlled with arb?
Use a combination of ARB with diuretic preferably thiazide diuretic. One brand in which it is available is Advantec.
@@MedNerdDrWaqasFazal you are doing absolutely fantastic job
Plz make video on hypernatremia correction
Hello doctor, my mom’s BP is usually above 140/90 even after being given Telmisartan+Hydrochlorothiadize 12.5 mg (half tablet) every day. She is unable to walk or do exercise due to bowed knees and recently came out of hospital after being treated for pneumonia + kidney damage in ICU for 12 days
Kindly suggest best treatment for her BP management
Sir 👌🏻👌🏻
Love you cute smilesh doctor❤
Make a lecture on hypotension and emergency treatment
sir, if patient has hypothyroidism and is taking levothyroxine 100 microgram OD , and is hypertensive , what should be drug of choice ?
Hi Dr Waqas, I hope you are doing well.
In regarding of deciding to starting patient on antihypertensive medication
Should the patient be started on monotherapy or dual therapy?
And for example patient blood pressure been noted to be 170/100
And last visit was 159/87
Thank you so much❤❤
My BF is 31. Has htn. Good shape eats healthy. He went to the ER three times during a weekend bp 183/114. They said oh yeah African Americans tend to get hypertension, here’s 5mg of amlodipine. That’ll do it… no prescription nothing. He was dizzy, severe headache the whole nine that was on Saturday morning, Saturday afternoon back in the ER gave 5 mg of amlodipine, this time gave 6 pills to take home. Sunday afternoon back in the ER only a few hours after taking amlodipine. I asked if they can give him an ace inhibitor. The doc said it takes a week or so for the amlodipine to work but stop taking your bp for a few days I think you’re just getting working up. I hate it here!
Hope everything worked out. Fod you go to regular family doctor for check up. Cut down on smoking drinking if he does
At which range of bp we can take injection Furesimide
Awesome
Sir, my mother is taking atenelol 50mg since 5 years and present she is doing fine. She was given beta blockers because she complained of palpitations. Now is there necessity to change into other first line drugs or continue medication for rest of her life?
thank you sir.
Hi Dr. Waqas
I have 48 years old patient who's blood pressure 148/87 and on next visit 147/82
He is morbidly Obese having symptoms of fatigue weight gain (BMI is 50) mood changes and infertility
I ordered basic labs plus TSH
His TSH was 7.61 with normal free t 3 and ft4 plus negative antiTPO antibodies, his ASCVD risk is 5%
T.cholesterol 233 LDL 170 HDL 46 and TG 81
Serum creatinine is 1.1
HBA1C is 6.2 FBS is 94
I started him on valsartan 80 mg
Rosuvastatin 10 mg
And metformin 750xr
Plus advise for lifestyle modifications
I postponed the treatment of subclinical hypothyroidism till after 3 months.
What are you suggestions please respond