Guideline for the diagnosis and management of hypertension in adults — 2016
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 (B...
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| Veröffentlicht in: | Medical journal of Australia 2016-07, Vol.205 (2), p.85-89 |
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| creator | 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 |
| description | 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 |
| doi_str_mv | 10.5694/mja16.00526 |
| format | Article |
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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.</description><identifier>ISSN: 0025-729X</identifier><identifier>EISSN: 1326-5377</identifier><identifier>DOI: 10.5694/mja16.00526</identifier><identifier>PMID: 27456450</identifier><language>eng</language><publisher>Australia</publisher><subject>Adult ; Animals ; Antihypertensive Agents - therapeutic use ; Australia ; Blood Pressure ; Blood Pressure Determination - instrumentation ; Blood Pressure Monitoring, Ambulatory - instrumentation ; Cardiovascular diseases ; Cardiovascular Diseases - prevention & control ; Female ; General medicine ; Humans ; Hypertension - classification ; Hypertension - diagnosis ; Hypertension - drug therapy ; Male ; Middle Aged ; Pharmaceutical preparations ; Risk Assessment ; Stroke - prevention & control</subject><ispartof>Medical journal of Australia, 2016-07, Vol.205 (2), p.85-89</ispartof><rights>2016 AMPCo Pty Ltd. All rights reserved</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3955-fdb0bad2a264ff706aeee8957e7101b865d749e20000c289f5360b1ecbdb670d3</citedby><cites>FETCH-LOGICAL-c3955-fdb0bad2a264ff706aeee8957e7101b865d749e20000c289f5360b1ecbdb670d3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.5694%2Fmja16.00526$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.5694%2Fmja16.00526$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,27901,27902,45550,45551</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/27456450$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Gabb, Genevieve M</creatorcontrib><creatorcontrib>Mangoni, Arduino A</creatorcontrib><creatorcontrib>Anderson, Craig S</creatorcontrib><creatorcontrib>Cowley, Diane</creatorcontrib><creatorcontrib>Dowden, John S</creatorcontrib><creatorcontrib>Golledge, Jonathan</creatorcontrib><creatorcontrib>Hankey, Graeme J</creatorcontrib><creatorcontrib>Howes, Faline S</creatorcontrib><creatorcontrib>Leckie, Les</creatorcontrib><creatorcontrib>Perkovic, Vlado</creatorcontrib><creatorcontrib>Schlaich, Markus</creatorcontrib><creatorcontrib>Zwar, Nicholas A</creatorcontrib><creatorcontrib>Medley, Tanya L</creatorcontrib><creatorcontrib>Arnolda, Leonard</creatorcontrib><title>Guideline for the diagnosis and management of hypertension in adults — 2016</title><title>Medical journal of Australia</title><addtitle>Med J Aust</addtitle><description>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.</description><subject>Adult</subject><subject>Animals</subject><subject>Antihypertensive Agents - therapeutic use</subject><subject>Australia</subject><subject>Blood Pressure</subject><subject>Blood Pressure Determination - instrumentation</subject><subject>Blood Pressure Monitoring, Ambulatory - instrumentation</subject><subject>Cardiovascular diseases</subject><subject>Cardiovascular Diseases - prevention & control</subject><subject>Female</subject><subject>General medicine</subject><subject>Humans</subject><subject>Hypertension - classification</subject><subject>Hypertension - diagnosis</subject><subject>Hypertension - drug therapy</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Pharmaceutical preparations</subject><subject>Risk Assessment</subject><subject>Stroke - prevention & control</subject><issn>0025-729X</issn><issn>1326-5377</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2016</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kL1OwzAURi0EoqUwsSOPSCjUdmI7GauKX7ViAYnNcuLr1lXilDgR6sZD8IQ8CaEtjNzl05WOznAQOqfkmossGVcrTcU1IZyJAzSkMRMRj6U8RENCGI8ky14H6CSEVf9SzuQxGjCZcJFwMkTzu84ZKJ0HbOsGt0vAxumFr4MLWHuDK-31AirwLa4tXm7W0LTgg6s9dh5r05VtwF8fn5gRKk7RkdVlgLP9jtDL7c3z9D6aPd09TCezqIgzziNrcpJrwzQTibWSCA0AacYlSEpongpuZJIBI_0VLM0sjwXJKRS5yYUkJh6hy5133dRvHYRWVS4UUJbaQ90FRVMimUw5T3r0aocWTR1CA1atG1fpZqMoUT_91Laf2vbr6Yu9uMsrMH_sb7AeGO-Ad1fC5j-Xmj9OWMrjb6PGefE</recordid><startdate>20160718</startdate><enddate>20160718</enddate><creator>Gabb, Genevieve M</creator><creator>Mangoni, Arduino A</creator><creator>Anderson, Craig S</creator><creator>Cowley, Diane</creator><creator>Dowden, John S</creator><creator>Golledge, Jonathan</creator><creator>Hankey, Graeme J</creator><creator>Howes, Faline S</creator><creator>Leckie, Les</creator><creator>Perkovic, Vlado</creator><creator>Schlaich, Markus</creator><creator>Zwar, Nicholas A</creator><creator>Medley, Tanya L</creator><creator>Arnolda, Leonard</creator><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20160718</creationdate><title>Guideline for the diagnosis and management of hypertension in adults — 2016</title><author>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</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3955-fdb0bad2a264ff706aeee8957e7101b865d749e20000c289f5360b1ecbdb670d3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2016</creationdate><topic>Adult</topic><topic>Animals</topic><topic>Antihypertensive Agents - therapeutic use</topic><topic>Australia</topic><topic>Blood Pressure</topic><topic>Blood Pressure Determination - instrumentation</topic><topic>Blood Pressure Monitoring, Ambulatory - instrumentation</topic><topic>Cardiovascular diseases</topic><topic>Cardiovascular Diseases - prevention & control</topic><topic>Female</topic><topic>General medicine</topic><topic>Humans</topic><topic>Hypertension - classification</topic><topic>Hypertension - diagnosis</topic><topic>Hypertension - drug therapy</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Pharmaceutical preparations</topic><topic>Risk Assessment</topic><topic>Stroke - prevention & control</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Gabb, Genevieve M</creatorcontrib><creatorcontrib>Mangoni, Arduino A</creatorcontrib><creatorcontrib>Anderson, Craig S</creatorcontrib><creatorcontrib>Cowley, Diane</creatorcontrib><creatorcontrib>Dowden, John S</creatorcontrib><creatorcontrib>Golledge, Jonathan</creatorcontrib><creatorcontrib>Hankey, Graeme J</creatorcontrib><creatorcontrib>Howes, Faline S</creatorcontrib><creatorcontrib>Leckie, Les</creatorcontrib><creatorcontrib>Perkovic, Vlado</creatorcontrib><creatorcontrib>Schlaich, Markus</creatorcontrib><creatorcontrib>Zwar, Nicholas A</creatorcontrib><creatorcontrib>Medley, Tanya L</creatorcontrib><creatorcontrib>Arnolda, Leonard</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Medical journal of Australia</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Gabb, Genevieve M</au><au>Mangoni, Arduino A</au><au>Anderson, Craig S</au><au>Cowley, Diane</au><au>Dowden, John S</au><au>Golledge, Jonathan</au><au>Hankey, Graeme J</au><au>Howes, Faline S</au><au>Leckie, Les</au><au>Perkovic, Vlado</au><au>Schlaich, Markus</au><au>Zwar, Nicholas A</au><au>Medley, Tanya L</au><au>Arnolda, Leonard</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Guideline for the diagnosis and management of hypertension in adults — 2016</atitle><jtitle>Medical journal of Australia</jtitle><addtitle>Med J Aust</addtitle><date>2016-07-18</date><risdate>2016</risdate><volume>205</volume><issue>2</issue><spage>85</spage><epage>89</epage><pages>85-89</pages><issn>0025-729X</issn><eissn>1326-5377</eissn><abstract>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.</abstract><cop>Australia</cop><pmid>27456450</pmid><doi>10.5694/mja16.00526</doi><tpages>5</tpages></addata></record> |
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| source | MEDLINE; Wiley Online Library Journals Frontfile Complete |
| subjects | Adult Animals Antihypertensive Agents - therapeutic use Australia Blood Pressure Blood Pressure Determination - instrumentation Blood Pressure Monitoring, Ambulatory - instrumentation Cardiovascular diseases Cardiovascular Diseases - prevention & control Female General medicine Humans Hypertension - classification Hypertension - diagnosis Hypertension - drug therapy Male Middle Aged Pharmaceutical preparations Risk Assessment Stroke - prevention & control |
| title | Guideline for the diagnosis and management of hypertension in adults — 2016 |
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