In a nutshell
This study reviewed recent recommendations treating hypertension.
Hypertension (high blood pressure) is a common condition that requires strict management of blood pressure. There are a number of strategies to achieve this including medication, exercise and diet alterations.
Choosing a treatment strategy depends on a number of factors and each patient benefits from a personalized approach. Understanding the factors that influence the suitability of treatments is very important. The European Society of Hypertension and the European Society of Cardiology recently updated their recommendations for the treatment of high blood pressure.
Methods & findings
This study reviewed strategies to improve blood pressure control in patients with hypertension.
Achieving a blood pressure target of 140/80 mmHg is ideal for patients with mild hypertension. Patients with high-risk hypertension should aim for blood pressure lower than 130/80 mmHg. Patients at high risk include those with diabetes and heart disease. Blood pressure management should be constant and variability between doctor visits should be reduced.
Lifestyle changes are very useful for blood pressure management. Dietary changes can lower blood pressure. The recommended daily salt intake is 5 grams. Heavy alcohol intake is detrimental, and should be limited in patients with hypertension. A diet with reduced saturated fats and cholesterol is important. Patients that are overweight or obese may benefit from losing weight, however this has not been conclusively proven. Exercise and higher levels of physical activity are associated with lower incidence of hypertension. A review of 54 clinical trials shows aerobic exercise significantly reduces blood pressure. Smoking is associated with increased blood pressure levels. The effects of non-medication strategies are not tested in large populations so the true effectiveness is not known.
Medications to treat hypertension are classed as follow: diuretics, beta-blockers, calcium antagonists, angiotensin converting-enzyme inhibitors and angiotensin receptor blockers. These drugs can be prescribed alone (monotherapy) or in combination (combination therapy). It is more difficult to manage blood pressure with one medication. This is because there may be several mechanisms involved in hypertension and multiple drugs may be required.
In certain cases, special considerations may be taken for patients in the following groups: elderly, young adults women, and patients with underlying conditions such as diabetes and heart disease.
The bottom line
This review discussed recent guidelines on managing hypertension.
The fine print
Although guidelines are useful, each patient will have a personalized approach that is feasible for them. It is not always possible to adopt lifestyle changes.
If you have any concerns regarding blood pressure management, please discuss with your physician.
Published By :
Oct 25, 2017