The Curbsiders Internal Medicine Podcast REBOOT: #509 Fresh Hypertension Guidelines. West Philadelphia Doc Jordy Cohen Keeps Our Hypertension Management Fresh
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May 11, 2026 
Jordana (Jordy) Cohen, nephrologist and hypertension expert from UPenn who helped write the AHA 2025 guidelines. She walks through flawless blood pressure measurement and validated home devices. She breaks down when to start combination pills, how to approach pregnancy and secondary causes, and why wearables are not yet ready for clinical use.
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Guest Shares Backpacking With Toddler Story
- Jordy Cohen described backpacking while carrying her 3.5-year-old in a pack as her current hobby.
- She recently hiked Shenandoah with her husband while carrying the child and enjoyed the workout despite attention from passersby.
Time In Range Predicts Long Term Risk
- Time-in-target matters: more frequent BP values below ~120 mmHg associate with substantially lower cardiovascular risk.
- The analogy to INR/CGM: more longitudinal BP data gives stronger predictive power for outcomes.
Start Fixed Dose Combination For Stage Two Hypertension
- For BP ≥140/90 start a fixed-dose combination (two drugs) upfront to improve adherence and likelihood of control.
- Prefer ARB + thiazide or ARB + calcium-channel combinations; choose telmisartan/olmesartan when tolerated and insured.