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Acta Cardiol Sin. 2017 May;33(3):213-225.

The 2017 Focused Update of the Guidelines of the Taiwan Society of Cardiology (TSOC) and the Taiwan Hypertension Society (THS) for the Management of Hypertension.

Author information

1
General Clinical Research Center, Division of Cardiology, Taipei Veterans General Hospital and National Yang-Ming University.
2
Cardiovascular Center and Division of Cardiology, Department of Internal Medicine, National Taiwan University Hospital, Taipei.
3
Division of Cardiology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung.
4
Department of Medicine, Mackay Medical College, and Cardiovascular Division, Department of Internal Medicine, Mackay Memorial Hospital, New Taipei City.
5
Division of Cardiology, Department of Internal Medicine, National Cheng Kung University Hospital, and Institute of Clinical Medicine, College of Medicine, National Cheng Kung University, Tainan.
6
Department of Medical Education, Taipei Veterans General Hospital and Department of Medicine and Institute of Public Health and Community Medicine Research Center, National Yang-Ming University, Taipei.
7
Department of Internal Medicine, National Cheng Kung University College of Medicine and Hospital, Tainan.
8
Department of Medical Education, Taipei Veterans General Hospital, Department of Medicine, National Yang-Ming University School of Medicine.
9
Division of Cardiology, Shin Kong Wu Ho-Su Memorial Hospital, Taipei.
10
Department of Internal Medicine, School of Medicine, Chung-Shan Medical University Hospital.
11
Division of Cardiology, Kuang Tien General Hospital, Taichung.
12
Division of Cardiology, Department of Internal Medicine; Heart Failure Center; Healthcare Center, Chang Gung Memorial Hospital, Chang Gung University College of Medicine.
13
Division of Cardiology, Taipei Veterans General Hospital and National Yang-Ming University.
14
General Clinical Research Center, Taipei Veterans General Hospital, School of Medicine, National Yang-Ming University, Taipei.
15
Division of Cardiology, Taichung Veterans General Hospital, Taichung.
16
Fu Jen Catholic University Hospital, New Taipei City.
17
Kaohsiung Municipal United Hospital, Kaohsiung.
18
Chollege of Medicine, China Medical University, Taichung.
19
Division of Cardiology, Poh-Ai Hospital, Yilan.
20
Department of Internal Medicine, Section of Cardiology, Chang Gung University Hospital College of Medicine, Chang Gung Memorial Hospital, Taoyuan.
21
Cardiovascular Research Laboratory, Cardiovascular Center, Big Data Center, China Medical University Hospital, China Medical University, Taichung.
22
Department of Medical Research, Taipei Veterans General Hospital, School of Medicine, National Yang-Ming University, Taipei, Taiwan.

Abstract

Hypertension (HT) is the most important risk factor for cardiovascular diseases. Over the past 25 years, the number of individuals with hypertension and the estimated associated deaths has increased substantially. There have been great debates in the past few years on the blood pressure (BP) targets. The 2013 European Society of Hypertension and European Society of Cardiology HT guidelines suggested a unified systolic BP target of 140 mmHg for both high-risk and low-risk patients. The 2014 Joint National Committee report further raised the systolic BP targets to 150 mmHg for those aged ≥ 60 years, including patients with stroke or coronary heart disease, and raised the systolic BP target to 140 mmHg for diabetes. Instead, the 2015 Hypertension Guidelines of the Taiwan Society of Cardiology and the Taiwan Hypertension Society suggested more aggressive BP targets of < 130/80 mmHg for patients with diabetes, coronary heart disease, chronic kidney disease with proteinuria, and atrial fibrillation patients on antithrombotic therapy. Based on the main findings from the Systolic Blood Pressure Intervention Trial (SPRINT) and several recent meta-analyses, the HT committee members of the Taiwan Society of Cardiology and the Taiwan Hypertension Society convened and finalized the revised BP targets for management of HT. We suggested a new systolic BP target to < 120 mmHg for patients with coronary heart disease, chronic kidney disease with an eGFR of 20-60 ml/min/1.73 m2, and elderly patients aged ≥ 75 years, using unattended automated office BP measurement. When traditional office BP measurement is applied, we suggested BP target of < 140/90 mmHg for elderly patients with an age ≥ 75 years. Other BP targets with traditional office BP measurement remain unchanged. With these more aggressive BP targets, it is foreseeable that the cardiovascular events will decrease substantially in Taiwan.

KEYWORDS:

Guidelines; Hypertension; Taiwan Hypertension Society; Taiwan Society of Cardiology

PMID:
28559651
PMCID:
PMC5445238

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