In a nutshell
This study reviewed published data to formulate guidelines on monitoring blood pressure and the risk of cardiovascular disease.
They made a number of recommendations including lowering the threshold for stage 1 and stage 2 hypertension, the use of continuous blood pressure monitoring and pharmacological treatment strategies.
Some background
Managing blood pressure is very important to prevent the development of additional complications. This includes cardiovascular (heart and circulatory system) disease, kidney disease and stroke. In order to reduce the risk of complications from hypertension (high blood pressure), doctors use a set of guidelines for diagnosis and treatment.
As research is ongoing, guidelines need to be updated to reflect recent findings and improve patient care. A review of these guidelines is performed by the American College of Cardiology (ACC) /American Heart Association (AHA) Task Force.
Methods & findings
The aim of this review was to determine blood pressure (BP) control guidelines for patients with or at risk of developing cardiovascular disease (CVD).
A writing committee selected by the ACC/AHA Task Force performed this study. This study included data from all relevant clinical trials. The analysis was divided into sections, to address each aspect of BP management.
BP level categories should be as follows: normal (less than 120/80 mmHg), stage 1 hypertension (130-139/80-89 mmHg) and stage 2 hypertension (greater than 140/90 mmHg). This change was due to evidence that CVD risk is increased even at BP levels of 120/80 mmHg. BP assessment outside of the doctor’s office is more beneficial for monitoring and managing medication.
Doctors should consider non-pharmacological intervention (no medication) as a treatment option. Medication should be considered in patients who have BP greater than 130 mmHg or diastolic pressure greater than 80 mmHg with CVD or a risk of CVD (greater than 10%). Patients with BP greater than 140 mmHg systolic (pressure when the heart is contracting) and/or 90 mmHg diastolic (pressure when the heart is at rest) should be prescribed medication to reduce BP.
Patients with CVD or a risk of atherosclerotic CVD should aim to reduce blood pressure to at least 130/80 mmHg. Thiazide diuretics, calcium channel blockers, angiotensin-converting enzyme (ACE) inhibitors and angiotensin II receptor blockers (ARBs) are recommended as the first line of medication for hypertension. Patients with stage 2 hypertension who are 20/10 mmHg higher than their BP target should be prescribed two drugs with different mechanisms of action.
The bottom line
The authors made a number of recommendations including lowering the threshold for stage 1 and stage 2 hypertension, the use of continuous blood pressure monitoring and pharmacological treatment strategies.
The fine print
The threshold for diagnosis of high blood pressure has been lowered from previous recommendations.
What’s next?
If you have any questions regarding these updated recommendations, please discuss with your doctor.
Published By :
Hypertension (Dallas, Tex. : 1979)
Date :
Nov 13, 2017
