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

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

*Corresponding author for this work

Research output: Contribution to journalArticleResearchpeer-review

121 Citations (Scopus)

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)≥160/100mmHg, start antihypertensive therapy. • The decision to treat at lower BP levels should consider absolute cardiovascular disease risk and/or evidence of endorgan damage, together with accurate BP assessment. • For patients at moderate absolute cardiovascular disease risk with persistent systolic BP≥140mmHg and/or diastolic BP≥90mmHg, start antihypertensive therapy. • Treat patients with uncomplicated hypertension to a target BP of <140/90mmHg 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 ≥140/90mmHg, as out-of-clinic BP is a stronger predictor of outcome. • In selected high cardiovascular risk populations, aiming for a target of <120mmHg systolic can improve cardiovascular outcomes. If targeting <120mmHg, 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, 140e159 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.

Original languageEnglish
Pages (from-to)85-89
Number of pages5
JournalMedical Journal of Australia
Volume205
Issue number2
DOIs
Publication statusPublished - 18 Jul 2016
Externally publishedYes

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  • Cite this

    Gabb, G. M., Mangoni, A., Anderson, C. S., Cowley, D., Dowden, J. S., Golledge, J., ... Arnolda, L. (2016). Guideline for the diagnosis and management of hypertension in adults — 2016. Medical Journal of Australia, 205(2), 85-89. https://doi.org/10.5694/mja16.00526