The following article is part of conference coverage from the 2019 American Academy of Physician Assistants Annual Meeting (AAPA 2019) in Denver, Colorado. Clinical Advisor’s staff will be reporting breaking news associated with research conducted by leading physician assistants. Check back for the latest news from AAPA 2019.


DENVER – Physician assistants (PAs) often advise patients to make lifestyle changes as a first line of treatment for hypertension, according to research presented at the American Academy of Physician Assistants 2019 meeting held May 18 to 22, 2019 in Denver, CO.

A group of investigators from the Physician Assistant Department at D’Youville College in New York conducted a study to assess how frequently PAs recommend lifestyle modifications as first-line treatment for patients with hypertension. They invited PAs to complete a 12-question survey that included questions about demographics and hypertension treatment practices.

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A total of 75 PAs were included in the analysis (mean age, 35 y; 77% women). The 3 most common specialties were family medicine (25%), internal medicine (21%), and primary care (17%).

All participants reported that they discussed lifestyle modifications with their patients as a treatment option for hypertension; nearly half of the population followed JNC 8 guidelines by recommending lifestyle changes as a first-line treatment for hypertension.

The majority of the population (79%) reported using lifestyle modifications as a treatment before medication for patients with a systolic blood pressure between 130 and 139 mm Hg; 60% recommended lifestyle changes for patients with a systolic blood pressure between 140 and 149 mm Hg.

Some of the most common reasons provided for not recommending lifestyle changes as first-line treatment included blood pressure being too high (85%), patient comorbidities (84%), poor patient adherence (61%), and situations in which patients requested medication (27%).

The most common lifestyle changes recommended included exercise (100%), weight loss (95%), reduced sodium intake (88%), smoking cessation (84%), and reduced alcohol consumption (57%).

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“Future research should be done to expand the research on this topic because it is important to know the reasons why some practitioners aren’t following the JNC [8] guidelines …”.

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Foster J, Michaels O, Walfriff M, Andreeff R, Edwards S. The use of lifestyle modifications as first line treatment for hypertension. Presented at: The American Academy of Physician Assistants Annual Meeting; May 18-22, 2019; Denver, CO. Poster 223.