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Guideline for the diagnosis and management of hypertension in adults - 2016

Citation

Gabb, GM and Mangoni, A and Anderson, CS and Cowley, D and Dowden, JS and Golledge, J and Hankey, GJ and Howes, FS and Leckie, L and Perkovic, V and Schlaich, M and Zwar, NA and Medley, TL and Arnolda, L, Guideline for the diagnosis and management of hypertension in adults - 2016, Medical Journal of Australia, 205, (2) pp. 85-89. ISSN 0025-729X (2016) [Non Refereed Article]


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DOI: doi:10.5694/mja16.00526

Abstract

The National Heart Foundation of Australia has updated the Guide to management of hypertension 2008: assessing and managing raised blood pressure in adults (updated December 2010). Main recommendations For patients at low absolute cardiovascular disease risk with persistent blood pressure (BP) ≥ 160/100 mmHg, start antihypertensive therapy. The decision to treat at lower BP levels should consider absolute cardiovascular disease risk and/or evidence of end-organ damage, together with accurate BP assessment. For patients at moderate absolute cardiovascular disease risk with persistent systolic BP ≥ 140 mmHg and/or diastolic BP ≥ 90 mmHg, start antihypertensive therapy. Treat patients with uncomplicated hypertension to a target BP of < 140/90 mmHg or lower if tolerated. Changes in management as a result of the guideline Ambulatory and/or home BP monitoring should be offered if clinic BP is ≥ 140/90 mmHg, as out-of-clinic BP is a stronger predictor of outcome. In selected high cardiovascular risk populations, aiming for a target of < 120 mmHg systolic can improve cardiovascular outcomes. If targeting < 120 mmHg, close follow-up is recommended to identify treatment-related adverse effects including hypotension, syncope, electrolyte abnormalities and acute kidney injury. Why the changes have been made A 2015 meta-analysis of patients with uncomplicated mild hypertension (systolic BP range, 140-169 mmHg) demonstrated that BP-lowering therapy is beneficial (reduced stroke, cardiovascular death and all-cause mortality). A 2015 trial comparing lower with higher blood pressure targets in selected high cardiovascular risk populations found improved cardiovascular outcomes and reduced mortality, with an increase in some treatment-related adverse events.

Item Details

Item Type:Non Refereed Article
Research Division:Medical and Health Sciences
Research Group:Cardiorespiratory Medicine and Haematology
Research Field:Cardiology (incl. Cardiovascular Diseases)
Objective Division:Health
Objective Group:Clinical Health (Organs, Diseases and Abnormal Conditions)
Objective Field:Cardiovascular System and Diseases
Author:Howes, FS (Dr Faline Howes)
ID Code:117611
Year Published:2016
Web of Science® Times Cited:25
Deposited By:Menzies Institute for Medical Research
Deposited On:2017-06-21
Last Modified:2017-06-21
Downloads:0

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