CLINICAL PRACTICE GUIDELINES Management of Hypertension

[Pages:160]MOH / P/ P AK / 3 9 1.18(GU )

CLINICAL PRACTICE GUIDELINES

Management of Hypertension

5TH EDITION (2018)

Malaysian Society of Hypertension

Ministry of Health Malaysia

Academy of Medicine of Malaysia

STATEMENT OF INTENT This guideline was developed to be a guide for best clinical practice in the management of hypertension. All efforts were made to ensure references quoted were the most current at the time of printing. Specific attempts were made to use local data and publications to ensure local relevance. Adherence to this guideline may not necessarily lead to the best clinical outcome in individual patient care. Every health care provider is responsible for the care of his/her unique patient based on the clinical presentation and treatment options available locally. However, adherence to this guideline is strongly recommended as a starting point in managing patients as it constitute the best available evidence at the time of writing.

REVIEW OF THE GUIDELINES This guideline was issued in 2018 and will be reviewed in 2023 or earlier if important new evidence becomes available. This is an update to the Clinical Practice Guideline on Management of Hypertension ? 4th Edition (published 2013) and supersedes the previous. Electronic version will be made available on the following websites: .my .my .my

DISCLOSURE STATEMENT The panel members had completed disclosure forms. None held shares in pharmaceutical firms or acted as consultants to such firms. Some may have been engaged as speakers in conferences or Continuing Professional Development activities mainly organised by the Malaysian Medical Association, the Malaysian Society of Hypertension, National Heart Association of Malaysia or similar professional non-governmental associations (NGOs). These events may or may not have received financial assistance from pharmaceutical companies as part of an educational grants (details are available upon request from the CPG Secretariat).

SOURCE OF FUNDING The development of the CPG on Management of Hypertension (5th Edition) was supported via unconditional educational grant from Servier Malaysia Sdn. Bhd. The funding body was not involved in and has no influence on the development of the guidelines. An independent third party was engaged for all secretarial task and was appointed by and reported directly to the Malaysian Society of Hypertension.

CLINICAL PRACTICE GUIDELINES - MANAGEMENT OF HYPERTENSION, 5TH EDITION (2018)

3

Key Messages

1. Hypertension is defined as persistent elevation of systolic BP of 140mmHg or greater and/or diastolic BP of 90 mmHg or greater.

2. The prevalence of hypertension in Malaysians aged 18 years and above was 35.3% in 2015, a slight increase from 33.6% in 2011.

3. Hypertension is a silent disease; unfortunately, in 2015, for every two diagnosed patients in Malaysia there are 3 undiagnosed patients. This has not changed since 2011. Blood pressure should be measured at every chance encounter.

4. Untreated or sub-optimally controlled hypertension leads to increased cardiovascular, cerebrovascular and renal morbidity/ mortality and overall mortality.

5. A systolic BP of 120 to 139 mmHg and/or diastolic BP of 85 to 89 mmHg is defined as `at risk blood pressure' and should be treated in certain high risk groups.

6. Healthy living should be recommended for all individuals with hypertension and `at risk blood pressure'.

7. Decisions on pharmacological treatment should be based on global vascular risks and not on the level of blood pressure per se.

8. In patients with newly diagnosed uncomplicated hypertension and no compelling indications, choice of first line monotherapy includes ACEIs, ARBs, CCBs, diuretics and ?-blockers.

9. Only 37.4% of Malaysian patients achieved blood pressure control ( ................
................

In order to avoid copyright disputes, this page is only a partial summary.

Google Online Preview   Download