International Society of Hypertension publishes new global hypertension practice guidelines

  • Unger T & al.
  • Hypertension
  • 6 May 2020

  • curated by Emily Willingham, PhD
  • Clinical Essentials
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  • The International Society of Hypertension has published its first set of guidelines developed to manage hypertension regardless of the population or a region’s resources.
  • The guidelines cover simplified minimum and optimal treatment approaches.

Why this matters

  • The Society says that around 72% of people with hypertension live in low- or middle-income regions.
  • Hypertension is a leading cause of death globally, linked to more than 28,000 deaths daily.
  • The authors of the guidelines say that their intent was to create concise, simplified guidelines that any health care worker could use anywhere around the world.

Key guidance

  • The guidelines cover testing, risk factors, comorbidities, and treatments, including lifestyle modifications and pharmacological treatment.
  • They also address resistant and secondary hypertension and hypertension in pregnancy.
  • The authors define hypertension in 2 grades.
    • The grade 1 hypertension threshold is >140/90 mmHg.
    • The grade 2 hypertension threshold is ≥160/100 mmHg.
  • The guidelines also take race/ethnicity into account.
  • Readers can access 2 versions of simplified treatment flow charts.
    • 1 version covers the minimum standards of care and essential recommendations.
      • Treatment under these guidelines should involve lifestyle interventions for grade 1, along with specialized pharmacological treatment in the case of certain age groups, comorbidities.
      • Under minimum standards, clinicians should “use any drugs available” and try to simplify the regimen with once-a-day dosing and single-pill combination therapies.
    • The other version features the optimal recommendations, or evidence-based standards of care.
      • Where possible, patients with grade 1 should be started on drug treatment concurrently with lifestyle adjustments, and pharmacotherapy should start immediately in patients with diabetes or kidney disease.