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Med J Aust. 2016 Jul 18;205(2):85-9.

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

Author information

1
Royal Adelaide Hospital, Adelaide, SA genevieve.gabb@sa.gov.au.
2
Flinders Medical Centre, Flinders University, Adelaide, SA.
3
The George Institute for Global Health, Sydney, NSW.
4
Princess Alexandra Hospital, Brisbane, QLD.
5
Australian Prescriber, Canberra, ACT.
6
Queensland Research Centre for Peripheral Vascular Disease, James Cook University, Townsville, QLD.
7
University of Western Australia, Perth, WA.
8
Royal Adelaide Hospital, Adelaide, SA.

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.

PMID:
27456450
[Indexed for MEDLINE]

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