Customize your JAMA Network experience by selecting one or more topics from the list below.
In Reply We thank Estol for his interest in our Viewpoint1 discussing the call for neurologists to accept the challenge of diagnosing and managing hypertension to prevent neurologic disease. We applaud their efforts to study hypertension within their health system, in particular the effort made to change the culture of young neurologists by educating them on the importance of measuring blood pressure.
Poor hypertension control often stems from missed opportunities rather than lack of knowledge.2 To avoid these missed opportunities, it is important to identify which neurologic conditions carry the highest prevalence of comorbid hypertension and which are primarily managed by neurologists rather than primary care physicians. Further understanding of patient and physician preferences for successfully managing hypertension is also needed. While in Estol’s particular health system hypertension was more successfully managed by neurologists than primary care physicians, evidence also suggests that large-scale hypertension interventions involving nursing and pharmacy staff can be highly successful and adapted to varied practice settings.3,4 We recognize that one size does not fit all but hope that over time health care systems will recognize the importance of studying and successfully implementing novel, individualized hypertension management strategies.
Corresponding Author: John Betjemann, MD, Zuckerberg San Francisco General Hospital, Department of Neurology, University of California, San Francisco, 1001 Potrero Ave, Bldg 1, Room 101, San Francisco, CA 94110 (firstname.lastname@example.org).
Published Online: March 2, 2020. doi:10.1001/jamaneurol.2020.0083
Conflict of Interest Disclosures: Dr Betjemann received personal compensation from JAMA Neurology that is not associated with this work as well as payment from the National Football League to serve as an unaffiliated neurotrauma consultant and consulting fees from Marinus Pharmaceuticals. No other disclosures were reported.
Identify all potential conflicts of interest that might be relevant to your comment.
Conflicts of interest comprise financial interests, activities, and relationships within the past 3 years including but not limited to employment, affiliation, grants or funding, consultancies, honoraria or payment, speaker's bureaus, stock ownership or options, expert testimony, royalties, donation of medical equipment, or patents planned, pending, or issued.
Err on the side of full disclosure.
If you have no conflicts of interest, check "No potential conflicts of interest" in the box below. The information will be posted with your response.
Not all submitted comments are published. Please see our commenting policy for details.
Betjemann J, Hemphill JC, Sarkar U. We Dropped the Reflex Hammer on Hypertension 20 Years Ago—Reply. JAMA Neurol. Published online March 02, 2020. doi:10.1001/jamaneurol.2020.0083
Coronavirus Resource Center
Create a personal account or sign in to: