Details

Autor(en) / Beteiligte

• Gabb, Genevieve M
• Mangoni, Arduino A
• Anderson, Craig S
• Cowley, Diane
• Dowden, John S
• Golledge, Jonathan
• Hankey, Graeme J
• Howes, Faline S
• Leckie, Les
• Perkovic, Vlado
• Schlaich, Markus
• Zwar, Nicholas A
• Medley, Tanya L
• Arnolda, Leonard

Titel

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

Ist Teil von

• Medical journal of Australia, 2016-07, Vol.205 (2), p.85-89

Ort / Verlag

Australia

Erscheinungsjahr

2016

Quelle

Wiley Blackwell Single Titles

Beschreibungen/Notizen

• Summary 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, 140–159 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.