Abstract
SummaryOutcomesExtensive data from many randomised, controlled trials have shown the benefit of treating hypertension (HTN). The target blood pressure (BP) for antihypertensive management is systolic < 140 mmHg and diastolic < 90 mmHg, with minimal or no drug side effects. Lower targets are no longer recommended. The reduction of BP in the elderly should be achieved gradually over one month. Co-existent cardiovascular (CV) risk factors should also be controlled.BenefitsReduction in risk of stroke, cardiac failure, chronic kidney disease and coronary artery disease.RecommendationsCorrect BP measurement procedure is described. Evaluation of cardiovascular risk factors and recommendations for antihypertensive therapy are stipulated. Lifestyle modification and patient education are cornerstones of management. The major indications, precautions and contra-indications are listed for each antihypertensive drug recommended. Drug therapy for the patient with uncomplicated HTN is either mono- or combination therapy with a low-dose diuretic, calcium channel blocker (CCB) and an ACE inhibitor (ACEI) or angiotensin receptor blocker (ARB). Combination therapy should be considered ab initio if the BP is ≥ 160/100 mmHg. In black patients, either a diuretic and/or a CCB is recommended initially because the response rate is better compared to an ACEI. In resistant hypertension, add an alpha-blocker, spironolactone, vasodilator or β-blocker.ValidityThe guideline was developed by the Southern African Hypertension Society 2014©.
Highlights
Outcomes: Extensive data from many randomised, controlled trials have shown the benefit of treating hypertension (HTN)
This is the sixth hypertension guideline published by the Southern African Hypertension Society (SAHS)
30.4% of the adult population have hypertension (HTN),[1] necessitating a simplified approach to assessment and treatment, which reflects realistic objectives that can be implemented by medical practitioners, nurse practitioners and pharmacists to diminish the impact of HTN and related cardiovascular disease (CVD) risk in this country
Summary
The objective of this guideline was to promote evidencebased, accessible and comprehensive management of HTN by healthcare professionals in the public and private sectors. Applicable HTN and CVD treatment and prevention guidelines were reviewed as well as HTN trials reporting clinical end-points, including those with individuals with important co-morbidities such as diabetes mellitus and chronic kidney disease.[3,4,5,6,7,8,9]
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