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1 Introduction Maintaining normal BP has been shown to significantly decrease the risk of cardiovascular events, including myocardial infarction, stroke, and chronic kidney disease (CKD) ( 2 Role of a healthy endothelium in the regulation of blood pressure 2.1 The endothelial cell layer While until the early 1980s it was believed that the endothelium had a solely passive role in organizing the vascular envelope and managing the selective passage of water and electrolytes alone, it is now known that this tissue performs numerous other vital functions

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doi: 10.1007/s11481-017-9752-7 126 ClineBHCosta-NunesJPCespuglioRMarkovaNSantosAIBukhmanYVet al

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What Payers Will Now Require Updated weight and BMI measurements Documented lifestyle changes and adherence to treatment Evidence of beneficial response to therapy Up-to-date comorbidity diagnoses in the medical record Proof that the medication continues to be medically necessary Stricter Ongoing Monitoring Expect payers to require: More frequent follow-up visits Updated chart notes for each renewal Standardized metabolic labs Gaps in follow-up or incomplete documentation could lead to denialseven for medically qualified patients