Use of noninvasive hemodynamics in hypertension management.

Hypertension is a chronic disease that is controlled in the United States in only 34% of those taking antihypertensive medications. Because hypertension is a hemodynamic disorder, the patient's hemodynamic profile before and after medical intervention may assist in the decision and evaluation of ongoing antihypertensive therapy. There are several medication classes used in the management of hypertension and it is challenging at best for the clinician to determine the optimal therapeutic combination of medications for each patient. Physician perceptions and patient symptoms are examples of barriers affecting the management and control of hypertension. Impedance cardiography is a noninvasive monitoring technique that provides reliable and reproducible hemodynamic measurements. Three case studies are presented that illustrate how hemodynamic parameters were used to achieve hypertension control in the outpatient setting.