Pharmacist Care Gets BP Patients to Goal Faster, Safer

At the New England Institute of Ambulatory Care Pharmacists (NEIAP) 2026 Annual Forum in Boston, Massachusetts, Anthony Ishak, PharmD, clinical pharmacist at Massachusetts General Hospital in Boston, Massachusetts, discussed with Pharmacy Times the expanding role of pharmacists in screening for primary aldosteronism and in the broader management of hypertension.

Ishak said recent guidelines have elevated when clinicians should consider primary aldosteronism, particularly for people with stage 2 hypertension. Rather than waiting until a patient is on 3 medications or shows signs of resistant hypertension, he argued for screening much earlier, and he described several points where pharmacists can contribute. Ishak highlighted the interplay of medications as a place where pharmacist expertise matters. While clinicians traditionally associate primary aldosteronism with low potassium, he noted that patients on angiotensin-converting enzyme inhibitor- or angiotensin II receptor blocker-based therapies whose potassium sits in the low-normal range may have the condition masked by their treatment—a nuance pharmacists are well positioned to catch. He added that screening earlier can help minimize the number of medications a patient needs and get them onto more effective treatment sooner.

Beyond identification, Ishak described a pharmacist role in the workup and in ongoing therapy: counseling patients on sodium loading and on the timing of medications that can affect lab results and titrating aldosterone-directed agents for the many patients who will not undergo surgical intervention. Given how many patients in the United States have hypertension, he said, generalists and specialists cannot screen every candidate alone.

Ishak reinforced that pharmacist involvement in home blood pressure monitoring and titration gets patients to their goal faster and more safely while freeing physicians and advanced practice providers to see more patients.