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“You can get past the dead end. You can break through the ceiling. I did and so have countless others.”

Clinical Pearl Wednesday #178

HYPERTENSION on green background

When initiating treatment in your patients who have hypertension, start with a low dose of medication and gradually titrate upward until the blood pressure goal is reached. This approach is known as “start low, go slow”.

This is important because some patients may experience side effects from the medication, such as dizziness, fatigue, or headaches. By starting with a low dose and gradually increasing it, patients are less likely to experience these side effects and are more likely to adhere to their medication regimen. I know I have had plenty of men’s health patients stop their BP medications because it caused erectile dysfunction!

Additionally, starting with a low dose can help avoid the risk of over-treating patients, which can lead to hypotension and its associated complications. Titration should be done carefully, with frequent blood pressure monitoring and medication side effects. Typically, monitoring should be done every 1-2 weeks to ensure adequate control.

So, “start low, go slow” is a valuable method to remember when treating hypertension. It can help improve medication adherence, reduce the risk of side effects, and avoid over-treatment.

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